bluuebunny/crossref_metadata_2025_split huggingface dataset:
Meal‐stimulated gastric acid secretion and integrated gastric acidity in gastro‐oesophageal reflux disease
Authors: Gardner J. D. , Sloan S. , Miner P. B. , Robinson M. 
Published: December 2004

SummaryBackground : No current methods exist to determine meal‐stimulated gastric acid secretion in humans under conditions that approximate those of daily living with the ingestion of breakfast, lunch and dinner.Methods : Gastric and oesophageal pH were measured in 26 healthy subjects and in 59 subjects with gastro‐oesophageal reflux disease. Meal‐stimulated gastric acid secretion was calculated from the buffer capacity of the meals determined in vitro and from the time required for the gastric pH to decrease to pH 2 in vivo following ingestion of the meal.Results : There was a significant correlation between gastric secretion with each meal and the corresponding post‐prandial integrated gastric acidity. There was also a significant correlation between meal‐stimulated gastric secretion and integrated gastric acidity from 09.00 to 22.00 h in both subjects with gastro‐oesophageal reflux disease and controls. In subjects with gastro‐oesophageal reflux disease, gastric secretion and integrated gastric acidity from 09.00 to 22.00 h were significantly higher than those in controls. There was a significant correlation between oesophageal acidity and integrated gastric acidity from 09.00 to 22.00 h in subjects with gastro‐oesophageal reflux disease.Conclusions : As post‐prandial gastric acidity is increased in subjects with gastro‐oesophageal reflux disease, it seems likely that increased gastric acidity is an important aetiological factor in this disease.
Azathioprine, mercaptopurine and birth outcome: a population‐based cohort study
Authors: Nørgård B. , Pedersen L. , Fonager K. , Rasmussen S.N. , Sørensen H. T. 
Published: December 2004

SummaryBackground : Data on the safety of azathioprine and mercaptopurine during pregnancy are very sparse.Aim : To examine the risk of adverse birth outcomes in women who took up prescriptions for azathioprine or mercaptopurine during pregnancy.Methods : This is a Danish cohort study based on data from a population‐based prescription registry, the Danish Birth Registry and the Hospital Discharge Registry. To examine the risk of congenital malformations, we included nine pregnancies exposed 30 days before conception or during the first trimester. To examine perinatal mortality, pre‐term birth and low birth weight, we included 10 pregnancies exposed during the entire pregnancy. Eleven different exposed women were included in the study. Outcomes were compared with those of 19 418 pregnancies in which no drugs were prescribed to the mothers.Results : Fifty‐five per cent of the exposed women had inflammatory bowel disease and 45% other diseases. Adjusted odds ratios for congenital malformations, perinatal mortality, pre‐term birth and low birth weight were 6.7 (95% confidence interval, 1.4–32.4), 20.0 (2.5–161.4), 6.6 (1.7–25.9) and 3.8 (0.4–33.3), respectively.Conclusions : Our results suggest that there is an increased risk of congenital malformations, perinatal mortality and pre‐term birth in children born to women treated with azathioprine or mercaptopurine during pregnancy. More data are needed to determine whether the associations are causal or occur through confounding.
A randomized controlled trial of a probiotic, VSL#3, on gut transit and symptoms in diarrhoea‐predominant irritable bowel syndrome
Authors: Kim H. J. , Camilleri M. , Mckinzie S. , Lempke M. B. , Burton D. D. , Thomforde G. M. , Zinsmeister A. R. 
Published: December 2004

SummaryAim : To investigate the effects of a probiotic formulation, VSL#3, on gastrointestinal transit and symptoms of patients with Rome II irritable bowel syndrome with predominant diarrhoea.Methods : Twenty‐five patients with diarrhoea‐predominant irritable bowel syndrome were randomly assigned to receive VSL#3 powder (450 billion lyophilized bacteria/day) or matching placebo twice daily for 8 weeks after a 2‐week run‐in period. Pre‐ and post‐treatment gastrointestinal transit measurements were performed in all patients. Patients recorded their bowel function and symptoms daily in a diary during the 10‐week study, which was powered to detect a 50% change in the primary colonic transit end‐point.Results : There were no significant differences in mean gastrointestinal transit measurements, bowel function scores or satisfactory global symptom relief between the two treatment groups, pre‐ or post‐therapy. Differences in abdominal bloating scores between treatments were borderline significant (P = 0.09, analysis of covariance). Further analysis revealed that abdominal bloating was reduced (P = 0.046) with VSL#3 [mean post‐ minus pre‐treatment score, − 13.7; 95% confidence interval (CI), − 2.5 to − 24.9], but not with placebo (P = 0.54) (mean post‐ minus pre‐treatment score, − 1.7; 95% CI, 7.1 to − 10.4). With the exception of changes in abdominal bloating, VSL#3 had no effect on other individual symptoms: abdominal pain, gas and urgency. All patients tolerated VSL#3 well.Conclusion : VSL#3 appears to be promising in the relief of abdominal bloating in patients with diarrhoea‐predominant irritable bowel syndrome. This is unrelated to an alteration in gastrointestinal or colonic transit.
Development and validation of the Diabetes Bowel Symptom Questionnaire
Authors: Quan C. , Talley N. J. , Cross S. , Jones M. , Hammer J. , Giles N. , Horowitz M. 
Published: December 2004

SummaryBackground : Although gastrointestinal symptoms occur frequently, there is no validated measure of gastrointestinal symptoms in patients with diabetes mellitus.Aim : To develop the Diabetes Bowel Symptom Questionnaire.Methods : A questionnaire derived from previously validated symptom measures was compiled to assess all relevant gastrointestinal and diabetes items. Face and content validity were ascertained by expert review. One hundred and sixty‐eight patients with diabetes mellitus completed the instrument, and reliability was evaluated by a test–re‐test procedure 1 week later. Concurrent validity was evaluated by an independent physician interview (n = 33). Measures of glycaemic control (glycated haemoglobin and plasma glucose) were compared with self‐reported glycaemic control on a five‐point Likert scale in diabetic out‐patients (n = 166).Results : The questionnaire had adequate face and content validity. There was good to excellent test–re‐test reliability for the gastrointestinal and diabetes items (median kappa: 0.63 and 0.79, respectively); concurrent validity was good to excellent (median kappa: 0.47 and 0.65, respectively), except for the items assessing the severity of gastrointestinal symptoms. Both glycated haemoglobin (P < 0.0001) and plasma glucose (P = 0.005) correlated significantly with self‐reported glycaemic control.Conclusion : The Diabetes Bowel Symptom Questionnaire appears to be a useful measure of gastrointestinal symptoms and glycaemic control in diabetes mellitus, and should have applicability in epidemiological and clinical studies.
Combined scintigraphic and pharmacokinetic investigation of enteric‐coated mesalazine micropellets in healthy subjects
Authors: Wilding I. R. , Behrens C. , Tardif S. J. , Wray H. , Bias P. , Albrecht W. 
Published: December 2004

SummaryBackground : There is a growing clinical trend to increase the daily dose of mesalazine, which leads to significant compliance issues associated with multiple dosings of current preparations.Aim : To examine the gastrointestinal performance and systemic exposure of a 1.5 g sachet (micropellets) mesalazine formulation, compared with three enteric‐coated tablets (500 mg each, Claversal).Methods : A randomized, two‐way, cross‐over pharmacoscintigraphic (scintigraphy plus pharmacokinetics) study and a two‐way, cross‐over, pharmacokinetic‐only study were performed in 24 healthy volunteers (12 subjects per investigation).Results : The relative bioavailability of mesalazine was 92% comparing micropellets with Claversal tablets, and the cumulative urine excretion was c. 26% for both preparations, suggesting comparable systemic exposure for the two types of preparation. In the majority of subjects, drug release from the micropellet formulation occurred predominantly in the terminal ileum and ascending colon. The Claversal tablets disintegrated in comparable intestinal sites, albeit at slightly later time points than the micropellets, principally due to slower gastric emptying for the single‐unit formulation.Conclusion : The 1.5 g micropellet formulation offers comparable delivery properties to the marketed tablets, but with greater convenience of dosing.
Esomeprazole‐based one‐week triple therapy with clarithromycin and metronidazole is effective in eradicating Helicobacter pylori in the absence of antimicrobial resistance
Authors: Miehlke S. , Schneider‐Brachert W. , Bästlein E. , Ebert S. , Kirsch C. , Haferland C. , Buchner M. , Neumeyer M. , Vieth M. , Stolte M. , Lehn N. , Bayerdörffer E. 
Published: December 2004

SummaryAim : This study aimed to investigate the effectiveness of a one‐week triple therapy with esomeprazole, clarithromycin and metronidazole for eradication of Helicobacter pylori infection in the absence of antimicrobial resistance.Methods : Patients testing positive for H. pylori susceptible to metronidazole and clarithromycin (E‐test) were randomized to receive a one‐week regimen with either esomeprazole 2 × 20 mg or omeprazole 2 × 20 mg in combination with clarithromycin 2 × 250 mg and metronidazole 2 × 400 mg. Follow‐up endoscopy with histology and culture and/or rapid urease test was performed 4–8 weeks after the end of treatment.Results : Eighty patients were randomized. Helicobacter pylori infection was cured in 38/39 patients of the esomeprazole group and 31/33 patients of the omeprazole group (per protocol 97.4% (95% confidence interval [CI], 86.2–99.9), 93.7% (95% CI, 79.2–99.2), P = 0.59); intention‐to‐treat 90.4% (95% CI: 77.4–97.3), 81.6% (95% CI: 65.7–92.3), respectively. No major side effects occurred. Minor side effects occurred in eight (20%) and six (23%) patients during esomeprazole and omeprazole therapy, respectively. Post‐treatment susceptibility testing revealed resistance to both metronidazole and clarithromycin in two of the three patients who failed.Conclusion : We conclude that esomeprazole, clarithromycin and metronidazole as one‐week triple therapy is effective for eradication of H. pylori in the absence of antimicrobial resistance.
Meta‐analysis: interferon for the treatment of chronic hepatitis C in dialysis patients
Authors: Fabrizi F. , Dulai G. , Dixit V. , Bunnapradist S. , Martin P. 
Published: December 2004

SummaryBackground : The efficacy of interferon monotherapy in dialysis patients with chronic hepatitis C remains unclear, although a number of small clinical trials have been published addressing this issue.Methods and aims : We evaluated the efficacy and safety of initial interferon monotherapy in dialysis patients with chronic hepatitis C by performing a systematic review of the literature with a meta‐analysis of clinical trials. The primary outcome was sustained virological response (as a measure of efficacy); the secondary outcome was drop‐out rate (as a measure of tolerability). We used the random effects model of Der Simonian and Laird, with heterogeneity and sensitivity analyses.Results : We have identified 14 clinical trials (269 unique patients); two were controlled studies. The mean overall estimate for sustained virological response (SVR) and drop‐out rate was 37%[95% confidence interval (CI) 28–48] and 17% (95% CI 10–28), respectively. The most frequent side‐effects requiring interruption of treatment were flu‐like symptoms (17%), neurological (21%) and gastrointestinal (18%). The overall weighted estimate for SVR in patients with hepatitis C virus genotype 1 was 30.6% (95% CI 20.9–48). In the sub‐group of clinical trials (n = 5) with standard interferon administration (3 million units [MUI] thrice weekly, subcutaneous route, 24‐week treatment), the overall mean estimate of SVR was 39% (95% CI 25–56). The studies were heterogeneous with regard to SVR and drop‐out rate.Conclusions : Tolerance to initial interferon monotherapy was lower in dialysis than nonuremic patients with chronic hepatitis C. However, more than one‐third of haemodialysis patients with chronic hepatitis C have been successfully treated with interferon. Longer duration of interferon monotherapy does not appear to have a beneficial effect on the response rate. Further studies are warranted to define the optimal anti‐viral regimen for chronic hepatitis C in dialysis population.
Effect of omeprazole 10 mg on intragastric pH in three different CYP2C19 genotypes, compared with omeprazole 20 mg and lafutidine 20 mg, a new H2‐receptor antagonist
Authors: Shimatani T. , Inoue M. , Kuroiwa T. , Horikawa Y. , Mieno H. , Nakamura M. 
Published: December 2004

SummaryBackground: Omeprazole 10 mg is used as maintenance therapy for gastro‐oesophageal reflux disease, but previous reports have not mentioned the potency of its acid suppression.Aim: To evaluate the potency of acid suppression with omeprazole 10 mg, in relation to CYP2C19 genotypes.Methods: Eighteen healthy subjects withoutHelicobacter pyloriparticipated. After a 7‐day regimen of omeprazole 10 mg, 20 mg, lafutidine 20 mg (a novel H2‐receptor antagonist) or water only (baseline data), intragastric pH was measured for 24 h.Results: With omeprazole 10 mg, greater differences were observed than 20 mg in median pH values and pH > 4 holding time ratios between poor metabolizers (PMs,n = 6) and the others [homozygous extensive metabolizers (homo‐EMs,n = 6) and heterozygous extensive metabolizers (hetero‐EMs,n = 6)]. With lafutidine 20 mg, these parameters were not influenced by the genotype. The potency of acid suppression was: omeprazole 20 mg ≈ lafutidine 20 mg > omeprazole 10 mg in homo‐EMs, omeprazole 20 mg > omeprazole 10 mg ≈ lafutidine 20 mg in hetero‐EMs, and omeprazole 20 mg ≈ omeprazole 10 mg > lafutidine 20 mg in PMs.Conclusions: Omeprazole 10 mg strongly suppresses acid secretion, but depending on the CYP2C19 genotypes shows greater interindividual variations in suppression than 20 mg.
Low‐dose furazolidone in triple and quadruple regimens for Helicobacter pylori eradication
Authors: Fakheri H. , Merat S. , Hosseini V. , Malekzadeh R. 
Published: December 2004

SummaryBackground : Furazolidone‐based regimens for the eradication of Helicobacter pylori are low cost and effective. Unfortunately, the usual dose of furazolidone is not tolerable in many patients. Lower doses of furazolidone are expected to cause fewer adverse effects.Aim : To investigate the efficacy of low‐dose furazolidone in the eradication of H. pylori.Methods : One hundred and fifty patients with duodenal ulcer and H. pylori infection were randomly assigned to one of three treatment groups: omeprazole 20 mg b.d., amoxicillin 1000 mg b.d. and furazolidone 100 mg b.d. for 14 days (OAF); omeprazole 20 mg b.d., amoxicillin 1000 mg b.d., furazolidone 100 mg b.d. and bismuth subcitrate 240 mg b.d. for 14 days (OABF1); or omeprazole 20 mg b.d., amoxicillin 1000 mg b.d., furazolidone 200 mg b.d. and bismuth subcitrate 240 mg b.d. for 14 days (OABF2).Results : Of the 150 patients, 145 completed treatment. The intention‐to‐treat and per protocol eradication rates were 54% (27/50), 72% (36/50) and 92% (46/50) for the OAF, OABF1 and OABF2 groups, respectively. The OAF and OABF1 groups showed significantly lower eradication rates than the OABF2 group (P < 0.001 and P < 0.01, respectively).Conclusions : Triple and quadruple furazolidone‐based H. pylori eradication regimens do not yield acceptable success rates when a low dose of furazolidone (100 mg b.d.) is used.
Needling revision of failed filtering blebs after trabeculectomy: a retrospective study
Authors: Fagerli Marit , Løfors Kjell T. , Elsås Tor 
Published: December 2004

Abstract.Purpose:  To determine the efficacy and safety of needling revision of failed filtering blebs. Methods:  We reviewed retrospectively 26 eyes that had undergone needling revision for a failed trabeculectomy. The needling revisions were performed either with adjunctive use of Mitomycin C, 5‐Fluorouracil or without antimetabolites. The procedure was usually performed as a clinic procedure, using a 27‐gauge needle. Results:  The mean follow‐up time was 14.5 ± 11.3 months (range 6.0–48.0 months). Intraocular pressure (IOP) decreased from 28.8 ± 6.8 mmHg (range 19.0–40.0 mmHg) to 15.3 ± 5.2 mmHg (range 7.0–35.0 mmHg). Twelve eyes (46.2%) achieved success, defined as IOP ≤ 18 mmHg without medication; 11 eyes (42.3%) achieved qualified success, defined as IOP ≤ 18 mmHg with antiglaucomatous medication, and three of 26 eyes (11.5%) were classified as failures. The success rate after the initial needling was 64% at 6 months and the same after 1 year and 2 years. The success rate after one or more needlings was 96% at 6 months and 77% at 1 year and 2 years. Complications developed in six of the 26 eyes (23.1%). These involved transient corneal epithelial defects in three eyes (11.5%), temporary conjunctival wound leak in two eyes (7.7%), and development of bullous keratopathy in one high risk eye (3.8%). Conclusion:  Our results are comparable to the results of other studies. Needling revision appears to be a useful tool in the management of glaucoma.
Intravitreal triamcinolone acetonide for the treatment of chronic pseudophakic cystoid macular oedema
Authors: Karacorlu Murat , Ozdemir Hakan , Karacorlu Serra 
Published: December 2004

Abstract.Purpose:  To evaluate the effect of intravitreal triamcinolone acetonide for chronic pseudophakic cystoid macular oedema (CME) resistant to medical treatment. Methods:  Six eyes of six patients with chronic pseudophakic CME, aged 58–74 years (average 66 years), made up the study population. All eyes had persistent CME despite having received medical treatment for at least 3 months. Intravitreal injection of 4 mg (0.1 ml) triamcinolone acetonide was offered to treat macular oedema. The visual and anatomic responses were observed as well as potential complications related to the injection procedure and corticosteroid medication. Results:  The follow‐up period was between 6 and 10 months (mean 8.5 months). Baseline central macular thickness averaged 504 µm. At 1 month, a reduction in the mean central macular thickness of 52% from 504 µm to 264 µm was obtained. At 3 and 6 months, the mean central macular thicknesses were 240 µm and 232 µm, respectively. Five of the six eyes maintained a visual gain of 15 or more letters from baseline at 6 months. During follow‐up no patient had intraocular pressure (IOP) exceeding 21 mmHg. No injection‐related complications were encountered. Conclusions:  Intravitreal triamcinolone acetonide is a promising therapeutic method for chronic pseudophakic CME resistant to medical treatment. Further study with a longer follow‐up period and larger series is warranted to assess the treatment's longterm efficacy and safety and the need for retreatment.
Age‐related Change of Somatostatin‐immunoreactive Neurones in the Main Olfactory Bulb of the Rat
Authors: Hwang I. K. , Lee J. C. , Park S.‐K. , An S.‐J. , Lee H. Y. , Lee Y.‐B. , Sohn H.‐S. , Lee I. S. , Kang T.‐C. , Won M. H. 
Published: December 2004

SummarySomatostatin is found in the olfactory system, including the main olfactory bulb (MOB), and is thought to be one of the neuroactive substances for olfaction. However, somatostatin immunoreactivity in the olfactory system has not been determined during ageing. Hence, we examined the age‐related changes of somatostatin‐immunoreactive (IR) neurones in the rat MOB over a period of 2 years, at the following various ageing stages: post‐natal month 1 (PM 1), PM 3, PM 6, PM 12 and PM 24. In PM 1 group, a few somatostatin‐IR neurones were detected in the granule cell layer (GCL), and had slender or oval somata and short processes. At PM 3, somatostatin‐IR neurones were observed in the glomerular, external plexiform and GCL. The size of somatostatin‐IR somata was larger than that at PM 1. In PM 6 group, the number and size of somatostatin‐IR neurones increased, and their processes became longer while running in various directions. At PM 12, somatostatin‐IR neurones increased in number, and their processes became markedly longer than those at PM 6. At this stage, somatostatin‐IR neurones had multipolar somata, and were the largest in size. In PM 24 group, somatostatin‐IR neurones were most numerous. However, the processes of somatostatin‐IR neurones were shorter than those at PM 12. This study suggests that the increased number of somatostatin‐IR neurones in the MOB of aged rats may play a role to compensate for any decrease of olfactory function.
‘Victoria on the Move’: Mental Health Services in a Decade of Transition 1992-2002
Authors: Meadows Graham , Singh Bruce 
Published: December 2004

Objective: Australia adopted a national mental health strategy in the early 1990s and each State has had to go through its own implementation process in the intervening years. The present paper describes the process of reform in services in Victoria, and ventures explanations as to why the process may have been more comprehensive and successful than in other States. Conclusions: Victoria adopted a Statewide ‘framework’, defining structural elements of area-based services, with rational resource distribution. A transitional process involving a population health approach and relatively rigid implementation of a tightly specified service framework, within a political environment that favoured strong health services management, was successful in achieving desired structural reforms in this State. This was undoubtedly at the cost of promoting a model of public mental health service delivery that is generally rationed so as to accept only a restricted range of types of referral. New initiatives from the current State government are explicitly targeted to correcting this situation.
Buddhism and Psychiatry: Confluence and Conflict
Authors: Meadows Graham 
Published: December 2004

Objective: To describe the relationship between Buddhism and psychiatry, from a personal perspective. Conclusions: The present paper introduces Buddhist thought for those unfamiliar with it, then describes some of the sites of confluence and conflict between this tradition and those of Western mental health care. It does so from the perspective of a Westerner who has made some exploration of Buddhism, mainly within one of the Tibetan traditions.