bluuebunny/crossref_metadata_2025_split huggingface dataset:
Autoimmune cholestatic liver disease in people with coeliac disease: a population‐based study of their association
Authors: Lawson A. , West J. , Aithal G. P. , Logan R. F. A. 
Published: February 2005

SummaryBackground : Population data supporting an association between the autoimmune cholestatic liver diseases, primary biliary cirrhosis and primary sclerosing cholangitis and coeliac disease, is limited and at times contradictory.Aim : To explore the relationship between coeliac disease and both primary biliary cirrhosis and primary sclerosing cholangitis within the General Practice Research Database, a UK‐based longitudinal primary care database.Methods : We identified 4732 people with diagnosed coeliac disease and 23 620 age‐ and sex‐matched controls within the General Practice Research Database. We calculated the prevalence of primary biliary cirrhosis and primary sclerosing cholangitis for both the coeliac disease and control group.Results : There was a higher prevalence of primary biliary cirrhosis in adults with coeliac disease, compared with controls [0.17% vs. 0.05%, odds ratio 3.63 (95% confidence interval: 1.46–9.04)]. Primary sclerosing cholangitis was also more common in the coeliac disease group [0.04% vs. 0%, fishers exact test (P = 0.03)].Conclusions : There was a threefold or greater increase in risk of both primary biliary cirrhosis and primary sclerosing cholangitis in people with coeliac disease compared with the general population. The association with primary biliary cirrhosis was weaker than in some reports and it is difficult on the basis of this study to justify screening patients with coeliac disease for either primary biliary cirrhosis or primary sclerosing cholangitis.
Meta‐analysis: the influence of pre‐treatment with a proton pump inhibitor on Helicobacter pylori eradication
Authors: Janssen M. J. R. , Laheij R. J. F. , de Boer W. A. , Jansen J. B. M. J. 
Published: February 2005

SummaryBackground : There is much debate about the influence of pre‐treatment with a proton pump inhibitor on Helicobacter pylori eradication. The few studies investigating the influence of pre‐treatment on triple and quadruple therapies did not find differences in eradication rates. However, the high eradication rates make it difficult to study factors associated with therapy failure in small populations. In order to overcome this problem we performed a meta‐analysis.Methods : The literature was searched in order to identify randomized clinical trials comparing modern triple/quadruple therapies for H. pylori eradication without pre‐treatment with a proton pump inhibitor with exactly the same regimen with pre‐treatment. The overall risk difference (with − without pre‐treatment) was calculated by pooling the risk differences of the individual studies weighted by the inverse of their variances.Results : Nine studies, investigating a total of 773 patients, were identified. There was considerable variation regarding therapy regimen and duration. Pooled eradication rates were 81.3% (312 of 384) for patients with pre‐treatment and 81.2% (316 of 389) for patients without pre‐treatment. The (weighted) overall risk difference was 0.1% (95% CI: −5%; 5%).Conclusion : Pre‐treatment with a proton pump inhibitor does not influence H. pylori eradication.
Oral methotrexate in ulcerative colitis
Authors: Cummings J. R. F. , Herrlinger K. R. , Travis S. P. L. , Gorard D. A. , McIntyre A. S. , Jewell D. P. 
Published: February 2005

SummaryBackground : We performed an audit of methotrexate for ulcerative colitis, because efficacy is unclear.Aim : To investigate the role of methotrexate in the management of ulcerative colitis.Methods : Patients with ulcerative colitis treated with oral methotrexate at the inflammatory bowel disease clinics of Oxford and Wycombe General Hospital, UK, were evaluated. Efficacy was defined by remission (complete steroid withdrawal for >3 months) and response (good, partial or nil, proportionate reduction of steroids).Results : There were 50 patients (42 ulcerative colitis alone; eight had rheumatoid arthritis associated with ulcerative colitis and were analysed separately). Indications for methotrexate in ulcerative colitis alone were azathioprine intolerance (31 of 42) and lack of benefit from azathioprine (11 of 42). The mean dose of methotrexate in ulcerative colitis alone was 19.9 mg/week for a median of 30 weeks (range: 7–395). Remission occurred in 42%. The response was good in 54% and partial in 18%. Side‐effects occurred in 23%; 10% stopped treatment because of side‐effects. Of those treated with methotrexate because of treatment failure with azathioprine, three of 11 achieved remission, but four came to colectomy within 90 days of starting methotrexate. The colitis remained in remission in seven of eight of those with RA treated with methotrexate and ulcerative colitis (mean dose 15.0 mg/week).Conclusion : Oral methotrexate (approximately 20 mg/week) is well‐tolerated and moderately effective in steroid‐dependent or steroid‐refractory patients with ulcerative colitis.
Efficacy and tolerability of a new formulation of sodium phosphate tablets (INKP‐101), and a reduced sodium phosphate dose, in colon cleansing: a single‐center open‐label pilot trial
Authors: Khashab M. , Rex D. K. 
Published: February 2005

SummaryBackground : The tablet form of sodium phosphate for bowel preparation for colonoscopy contains microcrystalline cellulose. This inactive ingredient produces a residue that obscures mucosal visualization and is time‐consuming to remove during colonoscopy.Aim : To perform an open‐label study of efficacy and tolerability of a modified formulation with microcrystalline cellulose reduced by 50% (code named INKP‐101) and a lower total dose of sodium phosphate.Methods : Patients scheduled for colonoscopy self‐administered 28 INKP‐101 tablets (42 g sodium phosphate). Colon cleansing efficacy was evaluated using a standard 4‐point scoring system and the amount of microcrystalline cellulose present and time spent removing it using an 8‐point scale.Results : A total of 31 patients were screened and enrolled. Thirty patients had a colonoscopy and were evaluated for colon cleansing efficacy. Overall colon cleansing was rated as excellent and good in 90% and 10% of patients respectively. About 77% of patients had microcrystalline cellulose scores of 2 or 3 (corresponding to <1 or 1–2 min spent removing microcrystalline cellulose, respectively). The drug was well‐tolerated and adverse events were generally benign.Conclusion : A new formulation of sodium phosphate with reduced microcrystalline cellulose and a lower total dose of sodium phosphate was effective for colonoscopy and well‐tolerated.
Review article: oral ulcers and its relevance to systemic disorders
Authors: Porter S. R. , Leao J. C. 
Published: February 2005

SummaryOral ulceration is a common problem, and is sometimes a marker of gastroenterological disease. Patients with signs or symptoms of oral ulcers are sometimes referred to gastroenterology clinics, however, in most instances the ulcers does not reflect gastrointestinal disease. Indeed, a spectrum of disorders other than those of the gut can give rise to oral mucosal ulcers ranging from minor local trauma to significant local disease such as malignancy or systemic illness. This present article reviews aspects of the aetiology, diagnosis and management of common ulcerative disorders of the oral mucosa.
Histological progression of non‐alcoholic fatty liver disease in Chinese patients
Authors: Hui A. Y. , Wong V. W.‐S. , Chan H. L.‐Y. , Liew C.‐T. , Chan J. L.‐Y. , Chan F. K.‐L. , Sung J. J.‐Y. 
Published: February 2005

SummaryBackground : Non‐alcoholic fatty liver disease is an important cause of chronic hepatitis and cryptogenic cirrhosis. The natural history of non‐alcoholic fatty liver disease is not well understood especially in Asian populations.Aim : To investigate the histological progression in Chinese patients with biopsy‐proven non‐alcoholic fatty liver disease.Methods : Chinese patients who had liver biopsy at least 3 years ago and confirmed to have non‐alcoholic fatty liver disease were invited for a second liver biopsy. Clinical and laboratory parameters related to their liver function and metabolic syndrome were recorded and analysed. Liver biopsies were scored for the degree of steatosis, necroinflammation and fibrosis. Correlation coefficients were calculated to assess the association between changes in histological scores and metabolic parameters.Results : Seventeen patients who had been followed up for a median period of 6.1 (range: 3.8–8.0) years underwent a second liver biopsy. Nine (53%) patients had progressive disease with worsening of fibrosis score. No statistically significant correlation was found between the changes in histological scores and metabolic parameters. Seven patients developed hypertension or diabetes mellitus during the period of follow‐up.Conclusions : Non‐alcoholic fatty liver disease is a progressive disease in Chinese patients as in their Caucasian counterparts. Diagnosis of non‐alcoholic fatty liver disease may predate development of new components of metabolic syndrome.
A randomized, double‐blind, placebo‐controlled trial of CDP571, a humanized monoclonal antibody to tumour necrosis factor‐α, in patients with corticosteroid‐dependent Crohn's disease
Authors: Feagan B. G. , Sandborn W. J. , Baker J. P. , Cominelli F. , Sutherland L. R. , Elson C. O. , Salzberg B. A. , Archambault A. , Bernstein C. N. , Lichtenstein G. R. , Heath P. K. , Cameron S. , Hanauer S. B. 
Published: February 2005

SummaryAim : To evaluate CDP571, a humanized monoclonal antibody to tumour necrosis factor‐α, for the treatment of corticosteroid‐dependent Crohn's disease.Methods : Patients with corticosteroid‐dependent Crohn's disease (use of prednisolone 15–40 mg/day or budesonide 9 mg/day for at least 8 weeks, a previous failed attempt to discontinue corticosteroids within 8 weeks, and Crohn's Disease Activity Index score 150 points or less) were enrolled in a 16‐week, randomized, double‐blind, placebo‐controlled trial. The patients received intravenous CDP571 (20 mg/kg at week 0 and 10 mg/kg at week 8) or placebo. Corticosteroid therapy was decreased following a predefined schedule. The primary efficacy end‐point was the percentage of patients with corticosteroid‐sparing [i.e. no disease flare (Crohn's Disease Activity Index score ≥220 points) and no longer requiring corticosteroid therapy] at week 10. The major secondary efficacy end‐point was corticosteroid‐sparing at week 16.Results : Seventy‐one patients received treatment. Corticosteroid‐sparing was achieved by 19 of 39 (48.7%) CDP571 patients and 13 of 42 (40.6%) placebo patients (P = 0.452) at week 10, and by 18 of 39 (46.2%) CDP571 patients and seven of 32 (21.9%) placebo patients (P = 0.032) at week 16. CDP571 therapy was well‐tolerated and the incidence of serious adverse events was similar to placebo.Conclusions : The CDP571 was effective for corticosteroid‐sparing at week 16 but not week 10, and was well‐tolerated in patients with corticosteroid‐dependent Crohn's disease.
Manometric evaluation of achalasia in the elderly
Authors: Hashemi N. , Banwait K. S. , Dimarino A. J. , Cohen S. 
Published: February 2005

SummaryBackground : The effect of ageing on oesophageal motility in patients with achalasia is not well described. Oesophageal contraction amplitude is decreased in otherwise healthy elderly subjects.Aim : To evaluate whether ageing influences the motor function of the oesophagus in achalasia.Methods : Initial manometry studies of patients with achalasia were reviewed and findings (lower oesophageal sphincter basal and residual pressures and oesophageal body contraction amplitudes) were compared between two groups of patients, those 65 years of age or older (49 patients) and those younger than 65 years (68 patients). The older group was further divided into those ≥70 years and those <70 years.Results : Patients 65 years and older had significantly higher lower oesophageal sphincter basal pressures compared with younger patients (65.6 ± 4.9 vs. 52.3 ± 2.7, P = 0.02). At an age cut‐off of 70 years, older patients had significantly higher basal (70.7 ± 1.6 vs. 53.0 ± 2.4, P = 0.02) and residual (19.7 ± 1.6 vs. 15.9 ± 0.7, P = 0.03) lower oesophageal sphincter pressures compared with younger patients. Amplitude of oesophageal contractions was not different between the groups. Across all age groups, there was no linear correlation between age and basal or residual lower oesophageal sphincter pressures (r = 0.28 and 0.12, respectively).Conclusions : Older patients with achalasia have higher lower oesophageal sphincter pressures, however there is no linear correlation between age and lower oesophageal sphincter pressures. Unlike healthy subjects, advanced age is not associated with a decrease in oesophageal contraction amplitude in patients with achalasia.
Budesonide as maintenance treatment in Crohn's disease: a placebo‐controlled trial
Authors: Hanauer S. , Sandborn W. J. , Persson A. , Persson T. 
Published: February 2005

SummaryAim : To assess the efficacy and safety of budesonide capsules 6 mg daily for prolongation of time to relapse and maintenance of remission in patients with Crohn's disease (CD) affecting the ileum and/or ascending colon.Methods : In a double‐blind, placebo‐controlled, multicentre trial, 110 patients with CD, who had previously achieved remission in a placebo‐controlled trial of budesonide 9 mg daily, were randomly assigned to receive budesonide 6 mg once daily or placebo for 52 weeks. Primary outcome measure was time to relapse [CD activity index (CDAI) of >150 plus an increase of at least 60 points from study entry or withdrawal due to clinical deterioration].Results : Median time to relapse was 360 days for budesonide patients; 169 days for placebo patients (P = 0.132). No significant differences were seen between groups in relapse rates at 1 year. Budesonide was safe and well tolerated, with a similar adverse events profile to placebo.Conclusion : Patients treated with budesonide 6 mg once daily had a trend towards a prolonged time to relapse and lower CDAI scores compared with patients treated with placebo, but relapse rates were not significantly different at the 1‐year end point.
Efficacy of esomeprazole 40 mg vs. lansoprazole 30 mg for healing moderate to severe erosive oesophagitis
Authors: Fennerty M. B. , Johanson J. F. , Hwang C. , Sostek M. 
Published: February 2005

SummaryBackground : Secondary analyses from previous studies indicated that esomeprazole was more effective than lansoprazole and omeprazole in healing moderate or severe (Los Angeles grades C or D) erosive oesophagitis (EE).Aim : To compare prospectively healing rates with esomeprazole vs. lansoprazole in patients with moderate to severe EE.Methods : In this multicentre, randomized, double‐blind, parallel‐group trial, adult patients with endoscopically confirmed moderate or severe EE received esomeprazole 40 mg (n = 498) or lansoprazole 30 mg (n = 501) once daily for up to 8 weeks. The primary end point was EE healing through week 8. Secondary assessments included investigator‐assessed resolution of symptoms and safety and tolerability.Results : Time to healing was significantly different (P = 0.007), favouring esomeprazole. Estimated healing rates at week 8 were 82.4% with esomeprazole 40 mg and 77.5% with lansoprazole 30 mg. Heartburn resolved at week 4 in 72% and 64% of patients who received esomeprazole and lansoprazole, respectively (P = 0.005). Control of other GERD symptoms was similar between treatments. Both treatments were well tolerated.Conclusions : With 8 weeks’ treatment, esomeprazole 40 mg once daily heals moderate to severe EE faster and in more patients, and resolves heartburn in more patients after 4 weeks of treatment, than lansoprazole 30 mg once daily.
Review article: monitoring of immunomodulators in inflammatory bowel disease
Authors: Aberra F. N. , Lichtenstein G. R. 
Published: February 2005

SummaryThe armamentarium of medications for the treatment of inflammatory bowel disease is growing and becoming more complicated to use. Immunomodulators are a class of medications that have found a niche for the treatment of Crohn's disease and ulcerative colitis. Because of the mounting supporting evidence for efficacy, the most commonly‐used immunomodulators are azathioprine, mercaptopurine, methotrexate and ciclosporin. These medications are being used more often due to their steroid‐sparing and potentially surgery‐sparing effects. Immunomodulators are also known for a significant side‐effect profile and require careful monitoring. This review provides the latest information for clinicians on efficacy, side‐effects, dosing and monitoring of these medications for treatment of inflammatory bowel disease.
Meta‐analysis: endoscopic variceal ligation for primary prophylaxis of oesophageal variceal bleeding
Authors: Khuroo M. S. , Khuroo N. S. , Farahat K. L. C. , Khuroo Y. S. , Sofi A. A. , Dahab S. T. 
Published: February 2005

SummaryBackground : The treatment effects of primary prophylactic endoscopic variceal ligation are unclear.Aim : To compare the treatment effects of endoscopic variceal ligation and β‐blockers for primary prophylaxis of oesophageal variceal bleeding. In addition, a subgroup analysis was done with the purpose to delineate differences in the effects of intervention that were biologically based.Methods : We performed a literature search for randomized controlled trials, which compared the treatment effects of endoscopic variceal ligation with β‐blockers for primary prophylaxis of oesophageal variceal bleeding. Of the 955 articles screened, eight randomized‐controlled trials including 596 subjects (285 with endoscopic variceal ligation and 311 with β‐blockers) were analysed. Outcomes measures evaluated were first gastrointestinal bleed, first variceal bleed, all‐cause deaths, bleed‐related deaths and severe adverse events. The measure of association employed was relative risk; with heterogeneity and sensitivity analyses.Results : Variceal obliteration was obtained in 261 (91.6%) patients and target β‐blockers therapy was achieved in 294 (94.5%) patients (P = 0.19). Endoscopic variceal ligation compared with β‐blockers significantly reduced rates of first gastrointestinal bleed by 31% (RR, 0.69; 95% CI: 0.49–0.96; P = 0.03; NNTB = 15) and first variceal bleed by 43% (RR, 0.57; 95% CI: 0.38–0.85; P = 0.0067; NNTB = 11). All‐cause deaths and bleed‐related deaths were unaffected (RR, 1.03; 95% CI: 0.79–1.36; P = 0.81 and RR, 0.84; 95% CI: 0.44–1.61; P = 0.60 respectively). Severe adverse events were significantly less in endoscopic variceal ligation compared with β‐blockers (RR, 0.34; 95% CI: 0.17–0.69; P = 0.0024; NNTB = 28). Sensitivity analysis of five trials published in peer review journals and four trials with high quality showed results similar to those seen in the primary analysis of all the eight trials, confirming stability of conclusions. Following variceal obliteration with endoscopic variceal ligation, oesophageal varices recurred in 83 (29.1%) patients. Seven (28.1%) patients bled with one fatal outcome. In subgroup analyses, endoscopic variceal ligation had significant advantage compared wtih β‐blockers in trials including ≤30% patients with alcoholic cirrhosis, >30% patients with Child Class C cirrhosis and >50% patients with large varices.Conclusions : In patients with cirrhosis with moderate to large varices and who have not bled, endoscopic varices ligation compared with β‐blockers significantly reduced bleeding episodes and severe adverse events, but had no effect on mortality.
Concomitant dosing of famotidine with a triple therapy increases the cure rates of Helicobacter pylori infections in patients with the homozygous extensive metabolizer genotype of CYP2C19
Authors: Okudaira K. , Furuta T. , Shirai N. , Sugimoto M. , Miura S. 
Published: February 2005

SummaryBackground : Proton‐pump inhibitors, such as lansoprazole, are metabolized in the liver by CYP2C19 and cannot inhibit acid sufficiently in homozygous extensive metabolizers of CYP2C19.Aim : To examine whether famotidine would increase the cure rates of Helicobacter pylori infection by a standard triple therapy.Methods : A total of 177 H. pylori‐positive patients were randomly assigned to either lansoprazole 30 mg b.d., clarithromycin 200 mg b.d. and amoxicillin 750 mg b.d. for 1 week (LCA group; n = 89) or famotidine 20 mg b.d., lansoprazole 30 mg b.d., clarithromycin 200 mg b.d. and amoxicillin 750 mg b.d. for 1 week (FLCA group; n = 88). Famotidine was administered after lunch and before sleep, and the others were after breakfast and dinner. CYP2C19 genotypes were determined by a polymerase chain reaction restriction fragment length polymorphism (PCR–RFLP) method.Results : In the LCA group, the eradication rates for homozygous extensive metabolizers, heterozygous extensive metabolizers, and poor metabolizers were 63%, 87%, and 100%, respectively (P = 0.014). Those in the FLCA group were 85%, 85%, and 100%, respectively (N.S.). The cure rate for homozygous extensive metabolizers in the FLCA group was significantly higher than that in the LCA group (P = 0.035).Conclusion : Famotidine improves the cure rate of H. pylori infection by a triple therapy in CYP2C19 homozygous extensive metabolizers patients.
Efficacy and safety of an olive oil‐based intravenous fat emulsion in adult patients on home parenteral nutrition
Authors: Reimund J.‐M. , Rahmi G. , Escalin G. , Pinna G. , Finck G. , Muller C. D. , Duclos B. , Baumann R. 
Published: February 2005

SummaryBackground : The most frequently used intravenous lipid emulsions are composed of 100% long chain triacylglycerols from soybean oil or of 50% long chain triacylglycerols–50% medium chain triacylglycerols. A newer emulsion, ClinOleic 20% containing 80% olive oil and 20% soybean oil, was suggested to reduce lipid peroxidation and immune function impairment.Aim : To assess ClinOleic 20%'s efficacy, safety and effect upon systemic inflammatory parameters in adults on home parenteral nutrition.Methods : In stable home parenteral nutrition patients, the initial intravenous lipid emulsion was changed for ClinOleic 20%. Nutritional status, clinical and biological tolerance, and systemic inflammatory markers were analysed before and after 1 and 3 months of home parenteral nutrition, with ClinOleic 20% as intravenous lipid emulsion.Results : Clinical and biological nutritional markers and inflammatory parameters did not differ between day 0 and month +3. There was no essential fatty acids deficiency. No side‐effects were reported. Three of five patients presenting with migraine during home parenteral nutrition infusion at day 0 felt consistently better at month +3.Conclusions : ClinOleic 20% is safe and efficient in adult home parenteral nutrition. It maintains normal essential fatty acids status and did not influence inflammatory parameters. In contrast to studies in preterm infants or paediatric patients, no effect on vitamin E concentration or lipid peroxidation was observed.