bluuebunny/crossref_metadata_2025_split huggingface dataset:
A multicenter, randomized, controlled trial of interferon alfacon‐1 compared with α‐2a‐interferon in Chinese patients with chronic hepatitis C virus infection
Authors: Yao Guang‐Bi , Fu Xi‐Xian , Tian Geng‐Shan , Xu Dao‐Zhen , Hao Lian‐Jie , Huangfu Yu‐Shan , Su Chun‐Xin 
Published: March 2003

Abstract Background: α −Interferons are the accepted therapy for patients infected with chronic hepatitis C virus (HCV) in China. However, consensus interferon (CIFN) for HCV treatment is effective in patients with chronic hepatitis C from Western countries.Methods: This randomized, controlled trial was conducted to determine the safety and efficacy of CIFN at two doses, and to compare it with α‐2a‐interferon (IFN‐α‐2a) in Chinese patients with chronic HCV. Interferon‐naive patients with chronic HCV infection (n = 187) were randomly chosen to receive 15 μg CIFN or 9 μg or 3 MU IFN‐α‐2a subcutaneously, three times a week for 24 weeks, followed by a 24 week observation period. Efficacy was evaluated by the normalization of serum alanine aminotransferase (ALT) and the non‐detectability disappearance of serum HCV‐RNA by using reverse‐transcription–polymerase chain reaction. The safety of CIFN was evaluated by recording the type and severity of adverse effects.Results: The combined ALT and HCV‐RNA end‐of‐treatment and sustained responses were observed to be greater for treatment with 15 μg CIFN (59.0% and 55.7%, respectively) compared to IFN α‐2a (36.1% and 39.3%, respectively; P = 0.01 for the end‐of‐treatment, P = 0.07 for the sustained response). The combined ALT and HCV‐RNA end‐of‐treatment and sustained responses for treatment with 9 μg CIFN (both 49.2%) were higher than those for IFN‐α‐2a (not statistically significant). Data were analyzed by using a logistic‐multiple‐variate regression model, which indicated that the higher IFN dose (15 μg or 9 μg CIFN vs 3 MU IFN‐α‐2a; P < 0.01) appeared to be associated with a better sustained response. The type, frequency and severity of adverse effects were comparable across treatment groups.Conclusions: Consensus interferon appears to be safe and effective at concentrations of 9 and 15 μg, but 15 μg CIFN may be more effective than 3 MU IFN‐α‐2a, without increased toxicity.
Status and natural course of GB virus C/hepatitis G virus infection among high‐risk groups and volunteer blood donors in Taiwan
Authors: Yu Ming‐Lung , Chuang Wan‐Long , Wang Liang‐Yen , Dai Chia‐Yen , Chiou Shyh‐Shin , Sung Ming‐Hsing , Chang Chao‐Sung , Chen Shinn‐Cherng , Wang Ching‐Shan , Chang Tai‐Tsung , Chang Wen‐Yu 
Published: March 2003

AbstractBackgroundHemophilia, thalassemia and uremia patients are at risk of parenterally transmitted infectious agents. The status and nature of the course of GB virus C/hepatitis G virus (GBV‐C/HGV) infection among these groups and blood donors in Taiwan was investigated.MethodsSerum GBV‐C HGV‐RNA and antibodies to GBV‐C/HGV envelope‐2‐protein (anti‐E2) were determined in 500 blood donors and in 44 hemophilia, 37 thalassemia and 85 uremia patients. Phylogenetic analysis was performed.ResultsThe prevalence of GBV‐C/HGV‐RNA and anti‐E2, respectively, was 38.6 and 27.3% in hemophilia patients, 27.0 and 27.3% in thalassemia patients, 14.1 and 10.6% in uremia patients and 3.4 and 7.2% in blood donors. The prevalence of GBV‐C HGV exposure was 59.1 and 51.4% in hemophilia and thalassemia patients, respectively, which was significantly higher than that for uremia patients (22.4%; P < 0.01) and blood donors (10.2%; P < 0.001). The anti‐E2 seroconversion rate was 66.7% in blood donors and 47.4, 36.8 and 34.6% in thalassemia, uremia (P < 0.05 compared with blood donors) and hemophilia (P < 0.01 compared with blood donors) patients, respectively. Discrepancies in the prevalence of GBV‐C HGV and hepatitis C virus infection were found among the three risk groups. Phylogenetic analysis showed that 51 of 56 GBV‐C HGV isolates clustered in group 3; the remaining five were of group 2a. Twelve of 39 viremic patients in the risk groups cleared the virus during the 4 year follow‐up period; seven developed concomitant anti‐E2 reactivity.ConclusionsGB virus C hepatitis G virus infection is epidemic among risk groups and GBV‐C HGV group 3 is the major strain in Taiwan. In the risk groups, approximately 18% of infections resolve with concomitant anti‐E2 seroconversion within 4 years.
Wilson’s disease presenting with rapidly progressive visual loss: Another neurologic manifestation of Wilson’s disease?
Authors: Gow Paul J , Peacock Sophie E , Chapman Roger W 
Published: March 2003

AbstractWilson’s disease (WD) is a rare autosomal recessive disorder of copper metabolism resulting in copper‐induced tissue damage that primarily involves the liver and central nervous system. The neurologic manifestations of WD almost universally involve a derangement of basal ganglia function or psychiatric disturbance. We report the case of a 46‐year‐old man presenting with end‐stage liver disease caused by WD who had associated rapidly progressive optic neuropathy. We also discuss the possible association between the two conditions.
Auditory P300 event‐related potentials and number connection test for evaluation of subclinical hepatic encephalopathy in patients with cirrhosis of the liver: A follow‐up study
Authors: Saxena Nandini , Bhatia Manvir , Joshi Yogendra K , Garg Pramod K , Tandon Rakesh K 
Published: March 2003

AbstractBackground and Aims: The P300 event‐related potentials (P3ERP) have been recently advocated for detection of cognitive disturbances in early encephalopathy. However, no systematic follow‐up study has been conducted to understand the clinical significance of subclinical hepatic encephalopathy (SHE) detected by this or other methods. The present study was therefore undertaken to examine the diagnostic usefulness of auditory P3ERP in the detection of SHE, to compare it with that of the number connection test (NCT), and to investigate the clinical outcome of patients with SHE in terms of progression to overt encephalopathy.Methods: P300 event‐related potential latencies were measured and the NCT time was recorded in 81 non‐encephalopathic cirrhotic patients (Aged 43.8 ± 11 years, 23 alcoholic and 58 non‐alcoholics) attending the outpatient department at our tertiary care hospital (All India Institute of Medical Sciences Hospital). Cut‐off values for abnormality in the tests were developed from age‐, sex‐ and education‐matched controls. Patients were followed up at regular intervals for the development of overt encephalopathy, and the identifiable precipitating factors were noted. The P3ERP latencies (363 ± 34 msec vs 349 ± 23 msec), as well as NCT time (54.6 ± 30.6 s vs 39.5 ± 15.8 s) were significantly prolonged (P < 0.01) in patients with liver cirrhosis when compared with the non‐cirrhotic controls.Results: The P3ERP defects were seen in 24.6% of cirrhotic patients, while NCT time was prolonged in 19.7% of the patients. Nearly 43% of the patients with SHE progressed to overt encephalopathy within a mean duration of 5 months, while only 3.9% of the non‐SHE patients did so. Of the patients who developed overt encephalopathy, 64.2% had P3ERP latency prolongations while 35.7% had abnormal NCT.Conclusions: The results of the present study suggest that P3ERP and NCT are valid tools for the screening of SHE in cirrhotic patients as there is a greater likelihood of overt encephalopathy development in patients with an abnormality detected by these tests than in patients with no such abnormality.
A randomized controlled comparison of three quadruple therapy regimens in a population with low Helicobacter pylori eradication rates
Authors: Sotudehmanesh Rasool , Malekzadeh Reza , Fazel Ali , Massarrat Sadegh , Ziad‐Alizadeh Behrooz , Eshraghian Mohammed Reza 
Published: March 2003

AbstractBackground and Aim: We sought to compare the efficacy and tolerability of an omeprazole/clarithromycin/bismuth/tetracycline‐based quadruple therapy to that of a ranitidine/metronidazole/bismuth/tetracycline‐based quadruple therapy of 2 or 3 weeks duration in a population with a high prevalence of metronidazole‐resistant Helicobacter pylori and low triple therapy eradication rates.Methods: Two hundred and twenty‐one patients who presented endoscopically proven duodenal ulcers and a positive rapid urease test were randomized to receive either: (i) omeprazole 20 mg b.i.d., clarithromycin 250 mg b.i.d., bismuth subcitrate 240 mg b.i.d. and tetracycline 500 mg b.i.d (OCBT) for 2 weeks; (ii) ranitidine 300 mg b.i.d., metronidazole 500 mg b.i.d, bismuth subcitrate 240 mg b.i.d. and tetracycline 500 mg b.i.d. (RMBT2) for 2 weeks; or (iii) ranitidine 300 mg b.i.d., metronidazole 500 mg b.i.d, bismuth subcitrate 240 mg b.i.d. and tetracycline 500 mg b.i.d. (RMBT3) for 3 weeks. Patients were interviewed 2 weeks after the completion of therapy to review compliance and side‐effects. Eradication of H. pylori was assessed 8 weeks after the completion of therapy with the use of a 14C‐urea breath test.Results: The per‐protocol eradication rate was significantly higher with OCBT (88%) than RMBT2 (73%) or RMBT3 (71%) (P < 0.05). The intent‐to‐treat eradication rate was numerically higher with OCBT (80%) than RMBT2 (68%) or RMBT3 (68%), although this difference did not reach statistical significance (P = 0.09). Per‐protocol or intent‐to‐treat eradication rates were similar with RMBT2 and RMBT3. There were significantly greater side‐effects with the RMBT2 regimen.Conclusions: The omeprazole/clarithromycin/bismuth/tetracycline‐based quadruple therapy provides higher H. pylori eradication rates than the ranitidine/metronidazole/bismuth/tetracycline‐based quadruple therapy when administered per protocol. The prolongation of the latter regimen from 2 to 3 weeks did not increase eradication rates.
Difference in quasispecies of the hypervariable region 1 of hepatitis C virus between alcoholic and non‐alcoholic patients
Authors: Takahashi Kou , Takahashi Toru , Takahashi Sumio , Watanabe Koji , Boku Saihiro , Matsui Shigeru , Arai Futoshi , Asakura Hitoshi 
Published: March 2003

AbstractBackground: Habitual alcohol intake is known to aggravate the clinical outcome of hepatitis C virus (HCV)‐related chronic liver diseases and to increase the risk of hepatocellular carcinoma.Methods: To investigate the possible mechanism of these effects by alcohol, we examined 31 cases of HCV‐related chronic liver diseases of which 17 cases were drinking just before admission and the remaining 14 cases were non‐drinkers. The studied cases included 18 patients with chronic hepatitis, six with liver cirrhosis and seven with hepatocellular carcinoma. The quasispecies of the hypervariable region 1 of the HCV genome were analyzed by using polymerase chain reaction–single strand conformation polymorphism (PCR‐SSCP). Hepatitis C virus viral load was quantitated by using multicyclic PCR after reverse transcription of the 5′ non‐coding region of the genome.Results: The mean PCR‐SSCP band number that reflected the quasispecies complexity in hypervariable region 1 was more significantly increased in alcoholics than in non‐alcoholics (5.5 ± 1.4 vs 3.9 ± 1.1, P < 0.01). The significant increase in alcoholics remained, even if the cases were restricted to males (P < 0.01), to HCV genotype 1b (P < 0.05) or to chronic hepatitis (P < 0.05). The HCV viral load was not statistically different between alcoholic and non‐alcoholic HCV‐related chronic liver diseases (5.02 × 106± 5.16 × 106 copies/mL vs 9.00 × 107± 2.75 × 108 copies/mL, P = 0.28). Mutation events seemed to occur randomly when amino acid sequences of hypervariable region 1 were compared between four drinkers and four non‐drinkers.Conclusions: The enhanced quasispecies complexity in hypervariable region 1 of HCV in alcoholics may be the main cause of more progressive HCV‐related chronic liver diseases, and may provide the disease the resistance against any therapeutic modalities including interferon.
Radiation therapy in combination with transcatheter arterial chemoembolization for hepatocellular carcinoma with extensive portal vein involvement
Authors: Tazawa Junichi , Maeda Manabu , Sakai Yoshinori , Yamane Michio , Ohbayashi Hideo , Kakinuma Sei , Miyasaka Yuka , Nagayama Kazuyoshi , Enomoto Nobuyuki , Sato Chifumi 
Published: March 2003

AbstractAim:The aim of this study was to examine the effectiveness and toxicity of radiation therapy in combination with transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) with extensive portal vein tumor thrombus (PVTT).Methods:The combined therapy was performed in 24 HCC patients with extensive PVTT. External radiation targeted for PVTT (50 Gy in 2 Gy fractions) was performed in combination with repetitive TACE for intralobar lesions using 30–60 mg epirubicin every 3 months, and associations of the following variables with the survival rate were evaluated: gender, age, viral etiology, Child’s class, performance status, extrahepatic metastasis, size and number of HCC, and location of PVTT.Results:The local response confined to PVTT was complete response (CR) in four patients, partial response (PR) in eight patients, no change (NC) in eight patients, and progressive disease (PD) in four patients. By using the stepwise Cox’s regression analysis, only Child’s class was associated with the survival rate. The survival rates after 1 and 2 years were 73 and 21% in Child’s A, 10 and 0% in Child B or C, and 61 and 21% in patients in whom the local response was CR or PR, and 19 and 9% in those in whom the local response was NC or PD, respectively. By using the multiple logistic regression analysis, Child’s class was the only factor associated with the local response (P = 0.006).Conclusions:The combined therapy is feasible and may be useful to reverse PVTT in patients with good hepatic function reserve.
A randomized open trial for comparison of proton pump inhibitors, omeprazole versus rabeprazole, in dual therapy for Helicobacter pylori infection in relation to CYP2C19 genetic polymorphism
Authors: Miyoshi Masatsugu , Mizuno Motowo , Ishiki Kuniharu , Nagahara Yasuhiro , Maga Toshirou , Torigoe Tomomi , Nasu Junichirou , Okada Hiroyuki , Yokota Kenji , Oguma Keiji , Tsuji Takao 
Published: March 2003

AbstractBackground and Aim: The genetic polymorphism of cytochrome P450 (CYP) 2C19 has been shown to influence the efficacy of Helicobacter pylori eradication therapy with a proton pump inhibitor (PPI) and amoxicillin (so‐called dual therapy). Omeprazole, a widely used PPI, and rabeprazole, a new PPI, are metabolized in different pathways in terms of CYP2C19 genetic polymorphisms. In this study, we compared the efficacy of omeprazole and rabeprazole in a 2‐week dual therapy in relation to CYP2C19 polymorphism.Methods: One hundred and ninety‐nine patients with peptic ulcer disease were randomly assigned to receive one of the following regimens: 500 mg t.i.d. amoxicillin together with either 20 mg b.i.d. omeprazole or 10 mg b.i.d rabeprazole. The eradication of H. pylori was evaluated by using a bacterial culture and a [13C]‐urea breath test at 1–2 months after completion of treatment. Cytochrome P4502C19 polymorphism was analyzed by using polymerase chain reaction–restriction fragment length polymorphism.Results: Intention‐to‐treat‐based cure rates for the omeprazole or rabeprazole regimens were 66.3% (95% CI, 56–75) and 62.4% (95% CI, 52–71), respectively, without significant difference. Cytochrome P4502C19 genetic polymorphism did not influence the cure rates in either of these regimens. We analyzed various factors associated with treatment failure (PPI, CYP2C19 genotype, and smoking habit) by using multiple logistic regression; smoking was the only significant independent factor for treatment failure.Conclusion Omeprazole and rabeprazole were equally effective in combination with amoxicillin in eradicating H. pylori, irrespective of the PPI used (omeprazole or rabeprazole) and CYP2C19 genetic polymorphism. Smoking significantly decreased the cure rate of H. pylori infection in the dual therapy.
Prediction of pancreatitis following endoscopic retrograde cholangiopancreatography by the 4‐h post procedure amylase level
Authors: Thomas Peter R , Sengupta Shomik 
Published: March 2003

AbstractBackground: Pancreatitis is the commonest and most significant complication of endoscopic retrograde cholangiopancreatography (ERCP). Early detection of post‐ERCP pancreatitis would allow the safe discharge of day‐case patients and targeted use of preventive therapies. Clinical diagnosis is inaccurate, and the aim of this study was to evaluate the 4‐h post‐ERCP hyperamylasemia as a predictor of pancreatitis.Methods: Two hundred and sixty‐three consecutive ERCPs performed at one center were prospectively analyzed, examining patient and procedure characteristics, as well as the amylase level as predictors of pancreatitis.Results: Younger age (< 25 years), Sphincter of Oddi dysfunction, pancreatogram and failed cannulation were risk factors for pancreatitis; sphincterotomy conferred an increased risk, which was not statistically significant. Hyperamylasemia was a highly sensitive and moderately specific predictor of pancreatitis. A cut‐off level of 1.5‐fold higher than normal was useful for the exclusion of pancreatitis, while a cut‐off level of threefold higher than normal was more specific, so as to target potential preventive therapies.Conclusions: The 4‐h post‐ERCP amylase level is a useful test to base management decisions on. It needs to be interpreted in conjunction with clinical assessment as well as identifiable risk factors related to the patient or the procedure.
Antibiotic susceptibility of Helicobacter pylori in the Chinese population
Authors: Yakoob Javed , Fan Xuegong , Hu Guoling , Liu Li , Zhang Zheng 
Published: March 2003

AbstractAim: To assess antibiotic susceptibility of Helicobacter pylori (H. pylori) strains to metronidazole, clarithromycin and tetracycline in the Chinese population, and to test the stability of antibiotic resistance in H. pylori 1 year after storage at −80°C.Methods: Fifty H. pylori strains isolated from patients with peptic ulcer disease were recovered from storage at −80°C. Susceptibility of these strains to metronidazole, clarithromycin and tetracycline was determined by using validated disk diffusion tests, which was repeated 1 year after storage at −80°C. The DNA profiles of each strain were determined by using the polymerase chain reaction‐based–random amplified polymorphic DNA fingerprinting technique (PCR‐RAPD). This was repeated if any change in antibiotic susceptibility pattern was noticed.Results: The resistance rate was 50% to metronidazole and 8% to clarithromycin. None of the strains was resistant to tetracycline. A dual resistance to metronidazole and clarithromycin was demonstrated in three H. pylori strains. The antibiotic susceptibility test reproduced itself in 92% (36 of 39) of the strains 1 year later; the three strains with dual resistance exhibited susceptibility to both antibiotics. Variation in antibiotic susceptibility pattern in the three H. pylori strains was associated with change in the RAPD fingerprint.Conclusion: The prevalence of resistance in H. pylori is high to metronidazole but low to clarithromycin in the Chinese population. The disk diffusion test appears to be a simple and reliable test, while antibiotic resistance in some H. pylori strains may disappear after long‐term storage at −80°C.
Safety of an ofloxacin‐based antitubercular regimen for the treatment of tuberculosis in patients with underlying chronic liver disease: A preliminary report
Authors: Saigal Sanjiv , Agarwal Shri Ram , Nandeesh Hosur Prabhuswamy , Sarin Shiv K 
Published: March 2003

AbstractBackground and Aims: Hepatotoxicity is a major side‐effect of antitubercular drugs (ATD). As these drugs are metabolized in the liver, there is a theoretical risk of increased hepatotoxicity in patients with underlying chronic liver disease (CLD). Ofloxacin has antitubercular activity and has exclusive renal clearance. The aim was to study the efficacy and safety of an ofloxacin‐based antitubercular regimen for treating tuberculosis in patients with underlying CLD.Methods: Thirty‐one cases were randomly assigned to two drug regimens using WHO dosage schedules: (i) regimen A (n = 15): isoniazid, rifampicin and ethambutol for 2 months, followed by isoniazid and rifampicin for a further 7 months; and (ii) regimen B (n = 16): isoniazid, pyrazinamide, ethambutol and ofloxacin for 2 months, followed by isoniazid, ethambutol and ofloxacin for a further 10 months. Hepatotoxicity was diagnosed if alanine aminotransferase/aspartate aminotransferase increased > fivefold from the baseline or to > 400 IU/L, or if bilirubin increased by > 2.5 mg/dL from the baseline.Results: The response to ATD was achieved in all the patients who completed the therapy. Four (26.6%) patients on regimen A developed hepatotoxicity as compared to none on regimen B (P = 0.043). None of these patients could be restarted on ATD using the same regimen A because of the persistently deranged liver functions.Conclusions: In patients with tuberculosis who have underlying CLD: (i) an ofloxacin‐based antitubercular regimen without rifampicin is as effective as a rifampicin‐based regimen; and (ii) a combination of isoniazid with rifampicin is more hepatotoxic than a combination with ofloxacin and pyrazinamide.
Upright versus supine reflux in gastroesophageal reflux disease
Authors: Ouatu‐Lascar Rodica , Lin Otto S , Fitzgerald Rebecca C , Triadafilopoulos George 
Published: March 2003

AbstractBackground:Postural measures are early recommendations in the management of heartburn, and are aimed at preventing acid reflux through an incompetent lower esophageal sphincter (LES). However, LES incompetence is found in only a minority of patients, and transient LES relaxations, primarily in the upright position, are currently recognized as the main pathophysiological abnormality in gastroesophageal reflux disease (GERD). We investigated the importance of supine acid reflux in patients with GERD.Methods:Upon review of their clinical, manometric, pH monitoring and endoscopic characteristics, 85 patients with reflux symptoms were classified into three groups: Group A (n = 22), consisting of symptomatic patients without esophagitis or pathological reflux; group B (n = 38), symptomatic patients with reflux but no endoscopic esophagitis; and group C (n = 25), symptomatic patients with both ulcerative or complicated esophagitis and pathological reflux.Results:All groups were similar in age distribution. Groups B and C had a higher prevalence of hiatal hernia and reflux symptoms. Manometry revealed similar LES pressures in groups A and B, but lower LES pressure in group C (P < 0.005). In groups A and B, supine reflux, in terms of percentage of time with pH < 4, was less pronounced than upright reflux (P < 0.0001). In contrast, group C supine reflux was as pronounced as the upright reflux.Conclusions:The majority of patients reflux in the upright position. Only patients with complicated esophagitis have significant bipositional acid reflux. These findings suggest that unless the patient has severe reflux disease, postural measures may not be indicated.