bluuebunny/crossref_metadata_2025_split huggingface dataset:
Porewater nutrient profiles and nutrient sediment–water exchange in a tropical mangrove waterway, Mapopwe Creek, Chwaka Bay, Zanzibar
Authors: Mohammed Salim M. , Johnstone Ron W. 
Published: March 2003

AbstractSediments were examined in the Mapopwe Creek, a tidally dominated mangrove waterway in the Chwaka Bay mangrove forest, Zanzibar, to assess their significance in the nutrient dynamics of the mangrove forest and the adjacent bay. Porewater concentrations of dissolved ammonium and that of soluble reactive phosphorus (SRP) were generally higher during the dry season than during the wet season. NO3− plus NO2− concentration averaged 1 µm and did not vary much between the two periods. Fluxes of ammonium ranged from −575 to 523 µm m−2 h−1 and those of SRP from −55.7 to 69.5 µm m−2 h−1. Measurements of NOx did not show any consistent fluxes of this dissolved nitrogen species. Variations of flux rates between the two seasons were not significant even though there were small variations in the flux direction in both nutrients. Results imply that Mapopwe sediments are a source of NH4+ but act as a sink for SRP.
The impact of elephants on the marula tree Sclerocarya birrea
Authors: Gadd Michelle E. 
Published: March 2003

AbstractThis study determined the abundance, density and population structure of the marula tree, Sclerocarya birrea, in three game reserves in South Africa, and assessed patterns and amounts of new and cumulative impact of elephants. Elephant feeding was very patchy so several attributes of individual trees, sampled transects and communities that might influence elephant herbivory were investigated. The incidence and type of elephant impact (bark, branch or stem breakage) were significantly related to tree diameter, but not to fruiting nor proximity to roads. At the transect level, elephant impact was influenced by density of marula trees, but was not influenced by proximity to roads, nor proportion of marula trees bearing fruits in the vicinity. At the community level, elephant impact was higher on reserves with higher total marula densities. Fourfold differences in elephant densities (0.08–0.30 elephants km−2) did not explain marula consumption: the percentage of trees with branch damage was similar across reserves and bark damage was inversely proportional to elephant density. Variation across reserves may reflect local and landscape‐level marula tree abundance, differences in alternative food plants and individual feeding habits. The recorded levels of impact appeared to be sustainable because mortality rates were low, affected trees often recovered, and small trees were not preferentially preyed upon.
Eradication of Helicobacter pylori infection induces an increase in body mass index
Authors: Azuma T. , Suto H. , Ito Y. , Muramatsu A. , Ohtani M. , Dojo M. , Yamazaki Y. , Kuriyama M. , Kato T. 
Published: March 2003

Background:The relationship between H. pylori infection and body mass indices is controversial.Aim:To investigate the relationship between H. pylori infection and body indices, and to examine the effect of H. pylori eradication therapy on body indices.Methods:Nine‐hundred and thirty‐two employees of an industrial corporation were examined for H. pylori infection and body mass indices. Three hundred and two H. pylori‐positive cases diagnosed with chronic gastritis by upper gastrointestinal endoscopy or radiography underwent eradication therapy. Body mass indices, serum total cholesterol levels and symptom scores were obtained before and at 12 months after eradication therapy.Results:There was no significant difference in body weight, body mass index (BMI) or serum total cholesterol level between the H. pylori‐positive and H. pylori‐negative groups. However, body weight and BMI increased significantly 12 months after eradication of H. pylori infection. In contrast, there was no significant difference in body weight and BMI 12 months after eradication therapy in the non‐eradication group. Serum total cholesterol levels did not change after eradication therapy in either the eradication or non‐eradication groups.Conclusion:Eradication of H. pylori infection induced an increase in BMI in industrial workers with chronic gastritis in Japan.
Gastric cancer and Helicobacter pylori
Authors: Axon A. 
Published: March 2003

SummaryGastric cancer is the second commonest cause of death from malignancy in the world. Its pathogenesis is comparatively well understood and its aetiology multifactorial. Non‐cardia gastric cancer usually arises in a stomach that has been inflamed over a long period and where atrophy and intestinal metaplasia have supervened. The commonest cause of gastric inflammation is infection with Helicobacter pylori. Colonization with this organism increases the relative risk of developing this cancer by about six [Helicobacter and Cancer Collaborative Group. Gut 2001; 49: 347–53]. Its likelihood increases with the severity and extent of the gastritis. Severity is influenced by the virulence of the infecting organism, the genetics of the host, bile reflux, dietary factors and the presence of hypochlorhydria which influences the extent, as well as the severity, of the inflammation. The only predisposing factor which can easily be manipulated is H. pylori infection, which can be successfully treated in 80–90% of cases using a 1‐week therapeutic regimen.
Review article: albumin in the treatment of liver diseases—new features of a classical treatment
Authors: Arroyo V 
Published: March 2003

SummaryAlbumin was introduced initially in the treatment of patients with cirrhosis and ascites to increase serum albumin concentration due to its oncotic effect. Although its administration declined some years later, at present it constitutes an essential treatment in clinical hepatology. Several studies have clearly demonstrated its efficacy in the prevention and treatment of circulatory dysfunction and hepatorenal syndrome in patients with cirrhosis. These effects can be due not only to its properties as a plasma expander but also to its capacity to bind numerous substances such as bile acids, nitric oxide and cytokines. Based on this capacity an albumin dialysis system (MARS) has recently been developed. The usefulness of this system in the management of patients with acute and chronic liver failure is, at present, under evaluation.
The role of the gastroenterologist in the provision of artificial nutrition support
Authors: Stockdale  , Williams  , Pennington  
Published: March 2003

Background:Nutrition support is required for the prevention or treatment of malnutrition in patients with intestinal failure and those who are unable to eat.Aims:To determine the demands upon gastroenterologists for nutrition support, the available resources, and compliance with the British Society of Gastroenterology (BSG) guidelines.Method:A questionnaire was circulated to all 483 consultant physician members of the BSG.Results:There were 336 (70%) replies. Fifty‐three per cent of respondents reported malnutrition in 20% or more of their patients. Seventy‐nine per cent of consultants supervised patients on enteral feeding, and 64% supervised parenteral feeding. Feeding jejunostomy was used by 61% of Teaching Hospital (TH) consultants but only 38% of District General Hospital (DGH) consultants (P < 0.001). Twenty‐seven per cent of respondents headed, or were members of, a nutrition support team (NST). Forty‐five and 38% of respondents did not follow written protocols for peripheral and central parenteral nutrition, respectively. Fifty‐five per cent monitored catheter complications, of whom 44% reported catheter infections in 5% or more of their patients. Weights of inpatients were obtained by 76% of DGH consultants and 91% of TH consultants (P < 0.001). Fifty‐eight per cent of respondents did not arrange for nutritional screening. Ninety‐six per cent of consultants could access a dietitian, 55% had access to an NST and 36% had a nutrition nurse specialist (NNS). An NNS was available to 57% of TH consultants but only 23% of DGH consultants (P < 0.001).Conclusions:Gastroenterologists have a major role in nutrition support. Facilities are suboptimal. Observing guidelines may improve nutritional care. These findings have implications for resources and training.
Interferon alpha with ribavirin for the treatment of chronic hepatitis C in non‐responders or relapsers to interferon monotherapy
Authors: Moreno‐Monteagudo  , Fernández‐Bermejo  , García‐Buey  , Sanz  , Iacono  , García‐Monzón  , Borque  , Moreno‐Otero  
Published: March 2003

Background:A more effective therapy for chronic hepatitis C virus‐infected patients is needed.Aim:To evaluate the efficacy, tolerance and timing of response to interferon alpha plus ribavirin in 60 patients with no response or reactivation after interferon alpha alone.Methods:Sixty patients, 42 non‐responders and 18 relapsers, received 3 million units three times weekly of interferon alpha‐2b plus 1–1.2 g ribavirin daily, for 6 months. Basal biochemical and virological (HCV RNA and genotype) parameters were determined. Clinical examination, recording adverse effects, and laboratory tests, including viraemia, were carried out at 1, 2, 3 and 6 months.Results:A significant (P < 0.001) progressive decrease of HCV RNA and alanine transaminase (ALT) levels was observed during treatment. On finalizing the sixth month, 42 patients (70%) had normal ALT and 26 (43.3%) were HCV RNA negative. Of these 26 complete responders, in 20 the viraemia was undetectable by the third month, while a late clearance at the sixth month of treatment was observed in six patients. Response rates were higher in previous responders to interferon alone (P < 0.05). Mild adverse effects appeared in 46 patients (79.6%), but only three were withdrawn due to serious side‐effects. Significantly (P < 0.001), haemoglobin and leucocytes decreased, and bilirubin, ferritin and uric acid increased in the first month of treatment, with no changes thereafter.Conclusions:Interferon alpha plus ribavirin progressively decreased HCV RNA and ALT levels, achieving a complete response in the six months of treatment in 26 (43.3%) patients. This combined therapy was well tolerated.
Indomethacin‐induced gastric antral damage in hamsters: are neutrophils involved?
Authors: Fitzpatrick  , Sakurai  , Le  
Published: March 2003

Background:A direct role for neutrophils in the pathophysiology of indomethacin‐induced gastric damage is controversial. Therefore, such damage was evaluated in hamsters.Methods:Gastric antral damage was evaluated 4 h after the oro‐gastric administration of indomethacin (30 mg/kg). Prior to indomethacin, hamsters were treated with various pharmacological agents: rebamipide, methotrexate or anti‐neutrophil serum (ANS). The number of circulating neutrophils was determined from Wright–Giemsa stained blood smears. Myeloperoxidase (MPO) activity was measured as a marker of gastric antral neutrophil infiltration.Results:Indomethacin caused primarily gastric antral damage. By histology, this damage did not penetrate the muscularis mucosa. A significant increase in gastric antral MPO activity was also found in indomethacin‐treated hamsters. Rebamipide decreased macroscopic gastric antral damage in a dose‐related fashion. Methotrexate treatment reduced the circulating blood neutrophil number by 38–44%, but did not affect gastric damage. ANS treatment resulted in near complete neutropenia, and also in a substantial reduction (84%) in gastric antral MPO activity. However, gastric antral damage was not significantly altered by ANS.Conclusions:Neutrophils are not directly involved in the pathophysiology of indomethacin‐induced damage to the hamster gastric antrum.
Failure of a 1‐day high‐dose quadruple therapy for cure of Helicobacter pylori infection
Authors: Wermeille  , Cunningham  , Armenian  , Zelger  , Buri  , Merki  , Hadengue  
Published: March 2003

Background:The optimal duration of treatment for eradication of Helicobacter pylori has still to be defined. A 1‐day high‐dose quadruple therapy with a combination of amoxycillin (or tetracycline), metronidazole, a bismuth salt and a proton pump inhibitor has led to eradication rates of 57–77%. In view of the high frequency of metronidazole‐resistant strains of H. pylori in Europe, we hypothesized that by using clarithromycin in place of metronidazole and by increasing the dose of proton pump inhibitor, the efficacy of a 1‐day high‐dose quadruple therapy could be improved.Methods:Patients were randomized to receive either amoxycillin 1000 mg b.d., clarithromycin 500 mg b.d. and lansoprazole 30 mg b.d. for 7 days, or amoxycillin 2000 mg q.d.s., clarithromycin 500 mg q.d.s., lansoprazole 30 mg t.d.s. and bismuth subcitrate 240 mg q.d.s. for 1 day.Results:It was originally intended to include 100 patients. The first planned interim analysis performed after follow‐up was completed for 30 patients revealed H. pylori eradication rates of 80% (12/15) in the 7‐day triple therapy group and 20% (3/15) in the 1‐day quadruple therapy group, the difference being highly significant (P = 0.003). Because the efficacy of the 1‐day treatment was so low, the study was stopped for ethical reasons. Eleven patients who failed with the 1‐day treatment were re‐treated with the 7‐day triple therapy: the eradication rate was 91% (10/11).Conclusions:One‐day high‐dose quadruple therapy with amoxycillin, clarithromycin, lansoprazole and bismuth subcitrate is dramatically less effective than the classic 7‐day triple therapy with the same antibiotics.
Review article: antibiotic prophylaxis for endoscopic retrograde cholangiopancreatography (ERCP)
Authors: Subhani  , Kibbler  , Dooley  
Published: March 2003

This review examines the evidence for antibiotic prophylaxis in endoscopic retrograde cholangiopan‐creatography (ERCP), and provides detailed advice about suitable antibiotic regimens in appropriate high‐risk patients.Ascending cholangitis and infective endocarditis are potential complications of endoscopic ERCP. The pathophysiology of these two complications is quite separate and different sub‐groups of patients require prophylaxis with appropriate antibiotic regimens.Ascending cholangitis results from bacterial infection of an obstructed biliary system, usually from enteric Gram‐negative microorganisms, resulting in bacteraemia. There is incomplete drainage of the biliary system after ERCP in up to 10% of patients who require stenting. Antibiotics started in these patients will probably reduce the frequency of cholangitis by 80%. If antibiotics are restricted to this group, ≈90% of all patients having an ERCP will avoid antibiotics, but 80% of cholangitic episodes will be prevented.Infective endocarditis may result from the bacteraemia caused at the time of the ERCP in patients with an abnormal heart valve. Antibiotic prophylaxis, in particular covering α‐haemolytic streptococci, should be started before the procedure in this defined high‐risk group.
Efficacy of omeprazole versus ranitidine for symptomatic treatment of poorly responsive acid reflux disease—a prospective, controlled trial
Authors: Maton P. N. , Orlando R. , Joelsson B. 
Published: March 2003

Background: H2‐receptor antagonists are widely used in patients with gastro‐oesophageal reflux disease (GERD) and are frequently continued when symptoms persist. Aim: To compare the efficacy of omeprazole 20 mg once daily with that of ranitidine 150 mg twice daily in relieving GERD symptoms, in patients who remained symptomatic following a 6‐week course of ranitidine therapy.Methods: Patients with heartburn on at least 4 days/week but who did not have endoscopy to assess oesophageal mucosa could participate. This two‐phase, prospective trial included a 6‐week open‐label phase (phase I), followed by an 8‐week double‐blind phase (phase II). Patients still symptomatic following treatment with ranitidine 150 mg twice daily (phase I) were randomized to double‐blind treatment (phase II) with either omeprazole 20 mg once daily or ranitidine 150 mg twice daily. The primary efficacy variable was the proportion of patients with heartburn resolution during weeks 4 and 8 of phase II.Results: Of the 533 patients with GERD who received ranitidine in phase I, 348 patients (65%) were still symptomatic. A total of 317 patients (59%) were randomized to double‐blind treatment (phase II). At week 8, a significantly (P < 0.0004) greater proportion of omeprazole‐treated patients (70%) experienced no more than mild heartburn compared with ranitidine‐treated patients (49%). Complete resolution of heartburn also occurred in a significantly (P < 0.00001) greater proportion of omeprazole‐treated patients (46% vs. 16% of the ranitidine group at week 8).Conclusions: After 6 weeks of ranitidine treatment, the majority of patients with GERD were still experiencing moderate to severe heartburn. Omeprazole was significantly more effective than ranitidine in resolving heartburn in this group of patients.
Impact of clarithromycin resistance on the effectiveness of a regimen for Helicobacter pylori: a prospective study of 1‐week lansoprazole, amoxycillin and clarithromycin in active peptic ulcer
Authors: Ducóns J. A. , Santolaria S. , Guirao R. , Ferrero M. , Montoro M. , Gomollón F. 
Published: March 2003

Background: Clarithromycin is a key antimicrobial in the combinations used to cure Helicobacter pylori infections, so there is a need to define the impact of in vitro resistance on in vivo results.Methods: A prospective trial was designed to study the effectiveness of the 1‐week combination of lansoprazole, clarithromycin and amoxycillin in 102 consecutive patients with active peptic ulcer. The pre‐treatment and post‐treatment sensitivity to amoxycillin, metronidazole and clarithromycin were studied by E‐test, and H. pylori status was defined by histology, culture and urease test at diagnosis and one month after treatment, and by urea‐breath test 2 months after treatment.Results: The eradication rate (intention‐to‐treat analysis) was 77% (95% CI: 69–86). No clinical factor was found to be different between eradicated and non‐eradicated patients. Clarithromycin‐resistant strains were found in 10 (10%; CI: 5–17) patients. The eradication rate was 20% (CI: 3–56) in these patients vs. 83% (CI: 75–91) in patients harbouring clarithromycin‐sensitive strains (P < 0.001). A logistic‐regression analysis confirmed clarithromycin resistance as the only factor associated with treatment failure.Conclusions: Clarithromycin resistance significatively impairs the effectiveness of the combination of lansoprazole, amoxycillin, and clarithromycin. The 80% efficacy goal will be difficult to reach in areas with high (>10%) primary clarithromyicin resistance, if currently recommended proton pump inhibitor‐triple therapies are used.
Comparison of two 3‐day Helicobacter pylori eradication regimens with a standard 1‐week regimen
Authors: Grimley  , Penny  , O’sullivan  , Shebani  , Lismore  , Cross  , Illing  , Loft  , Nwokolo  
Published: March 2003

Background: The duration of Helicobacter pylori eradication regimens has decreased to 1 week with cure rates of over 90%. This can be attributed to the use of triple drug regimens including potent inhibitors of gastric acid secretion and clarithromycin. There is no theoretical reason why shorter regimens should not be possible.Aim: To compare two 3‐day, low‐dose, twice daily regimens with 1 week of omeprazole 20 mg b.d., clarithromycin 250 mg b.d., and metronidazole 400 mg b.d. (OCM)Methods: Outpatients referred for gastroscopy were screened by biopsy urease test. H. pylori‐positive patients were randomized to receive either lansoprazole 30 mg b.d., tri‐potassium dicitrato bismuthate one tablet b.d., clarithromycin 250 mg b.d., and amoxycillin 1 g b.d. for 3 days (LTdbCA), or ranitidine bismuth citrate 400 mg b.d., clarithromycin 250 mg b.d. and amoxycillin 1 g b.d. for 3 days (RbcCA) or omeprazole 20 mg b.d., clarithromycin 250 mg b.d. and metronidazole 400 mg b.d. for 1 week (OCM). They were not pre‐treated with a gastric acid inhibitor. After 8 weeks, H. pylori status was assessed by 13C urea breath test.Results: 974 out of 1114 patients referred for gastroscopy were screened by biopsy urease test. 140 patients were not screened either because they were anticoagulated or for technical reasons. 334 patients were H. pylori‐positive: 154 were excluded mostly because of allergy to penicillin and personal reasons but 180 were randomized to treatment All regimens were well tolerated.For LTdbCA (n=60), RbcCA (n=59), and OCM (n=61) the H. pylori cure rates (95% CI) were 23% (12–34), 14% (5–23) and 87% (79–95), respectively, using intention‐to‐treat analysis and 25% (14–36), 15% (6–24) and 88% (80–96), respectively, if analysed per protocol. OCM was significantly superior to LTdbCA and RbcCA (P < 0.001) but there was no significant difference between regimens LTdbCA and RbcCA.Conclusions: OCM is an extremely effective H. pylori eradication regimen. The 3‐day regimens tested both have poor cure rates. Pre‐treatment with a proton pump inhibitor, higher doses or more frequent dosing may be necessary to increase the cure rate of short duration regimens. However, this could make them less acceptable than the H. pylori eradication regimens currently available.
Efficacy of two different dosage regimens of omeprazole, amoxycillin and metronidazole for the cure of Helicobacter pylori infection
Authors: Bayerdörffer  , Lonovics  , Dité  , Díete  , Domján  , Kisfalvi  , Mégraud  , Pap  , Sipponen  , Burman  , Zeijlon  
Published: March 2003

Background:While addition of metronidazole to the omeprazole–amoxycillin combination has been shown to be advantageous, the optimal dosage and drug distribution of the antimicrobials has not been sufficiently evaluated.Aim:To investigate the efficacy of two different regimens of omeprazole, amoxycillin and metronidazole for the cure of Helicobacter pylori infection.Methods:Two hundred and fifty‐five patients with H. pylori associated duodenal ulcers were randomly treated with either a 1‐week regimen of omeprazole 20 mg b.d., amoxycillin 1000 mg b.d. and metronidazole 800 mg b.d. (OAM b.d.) or a combination of omeprazole 40 mg o.d., amoxycillin 500 mg t.d.s. and metronidazole 400 mg t.d.s. (OAM t.d.s.). All patients subsequently received omeprazole 20 mg o.d. for an additional 3 weeks. H. pylori status was assessed by histology and 13C‐UBT prior to treatment and 8 weeks after randomization. Additional biopsies were obtained for H. pylori culture to determine primary and secondary resistance to metronidazole by agar dilution.Results:Two hundred and thirty‐seven patients were included in the intention‐to‐treat analysis and 198 patients in the per protocol analysis. With intention‐to‐treat analysis, the cure rate was 77% after treatment with OAM b.d. (95% CI, 69%–85%) and 76% after OAM t.d.s. therapy (95% CI, 67%–83%). Ulcer healing (intention‐to‐treat analysis) was documented in 95% of patients in the OAM b.d. group (n=122) and in 97% of patients in the OAM t.d.s. group (n=115). Adverse events were reported in 26 (20%) and in 18 (14%) patients in the OAM b.d. and OAM t.d.s. groups, respectively. None resulted in discontinuation of treatment. Overall primary resistance of H. pylori against metronidazole was found in 22 of 116 strains (19%).Conclusions:The combination of omeprazole, amoxycillin and metronidazole achieves about an 80% cure rate of H. pylori infection even in active ulcers. The total daily dose, and the choice of twice or three times daily dosing does not seem critical with this regimen.