bluuebunny/crossref_metadata_2025_split huggingface dataset:
Helicobacter pylori eradication does not worsen quality of life related to reflux symptoms: a prospective trial
Authors: Laine L. , Dhir V. 
Published: March 2003

Background:Concern has been raised that Helicobacter pylori therapy may lead to the development of gastro‐oesophageal reflux disease. This prospective study was designed to assess reflux‐related quality of life and the symptoms of gastro‐oesophageal reflux disease in patients undergoing H. pylori therapy.Methods:Patients with a primary complaint of dyspepsia (upper abdominal pain or discomfort) and endoscopic biopsy positive for H. pylori received triple therapy for 2 weeks. A validated reflux‐related quality of life questionnaire sensitive to change was given at baseline, 1 month and 6 months after therapy; symptoms were also recorded. A urea breath test was performed 1 month after the end of therapy; patients and investigators were blind to the results.Results: H. pylori was eradicated in 48 of 61 patients. The mean scores in cured patients for each of the five domains were comparable at baseline and 6 months after therapy: differences were − 0.23 to 0.13 (P > 0.20) on a scale of 1–7. The proportion of cured patients with a large decrease in quality of life (10–17% in the five domains) was similar to the proportion with a large increase (15–21%). Heartburn was present at baseline in 22 cured patients; at 6 months, it persisted in 13 and resolved in nine, whilst nine patients developed new heartburn.Conclusions:A population of patients presenting with dyspepsia should have no overall increase or decrease in quality of life due to symptomatic gastro‐oesophageal reflux disease in the 6 months after H. pylori therapy.
Determination of the time of onset of action of ranitidine and famotidine on intra‐gastric acidity
Authors: Gardner J. D. , Ciociola A. A. , Robinson M. , Mcisaac R. L. 
Published: March 2003

SummaryBackground : No standard methods exist for determining the onset of action of gastric antisecretory agents in human subjects.Methods : Intragastric pH was measured when placebo, ranitidine 150 mg, ranitidine 75 mg or famotidine 10 mg were administered 30 min after the end of a meal.Results : When the onset of action was defined as the earliest time that mean gastric pH with active treatment was statistically significantly higher (P < 0.05) than the corresponding placebo value, the onsets of action of ranitidine 75 mg and 150 mg were 55 min, and of famotidine 10 mg, 90 min. When onset was defined in terms of a particular decrease in gastric acid concentration for the group as a whole or for individual subjects, there was an important variation in the relative times of onset of ranitidine 75 mg and famotidine 10 mg.Conclusions : When administered after a meal, the onset of action of ranitidine and famotidine on gastric pH can be determined for individual subjects as well as for the group as a whole. When onset was determined for the group using statistical significance, which does not depend on arbitrary cut‐off points, ranitidine 75 mg had an earlier onset of action than did famotidine 10 mg.
Appropriateness of urea breath test: a prospective observational study based on Maastricht 2000 guidelines
Authors: Perri F. , Ricciardi R. , Merla A. , Piepoli A. , Gasperi V. , Quitadamo M. , Andriulli A. 
Published: March 2003

SummaryBackground : The urea breath test is routinely used for diagnosing or confirming the eradication of Helicobacter pylori.Aim : To evaluate the appropriateness of urea breath test referrals.Methods : The age, sex, symptoms, endoscopic findings, use of non‐steroidal anti‐inflammatory drugs, family history of gastric cancer or H. pylori infection and concomitant diseases of patients referred for urea breath testing in a 1‐year period were recorded. The appropriateness of urea breath test referrals was judged according to Maastricht guidelines.Results : One thousand, three hundred and twenty subjects (47 ± 16 years) were referred in 2001: 578 (43.8%) for the diagnosis and 742 (56.2%) for confirmation of the eradication of H. pylori. The urea breath test was considered to be appropriate in 836 (63.3%) patients, inappropriate in 192 (14.5%) and appropriate but avoidable in 292 (22.1%). The appropriateness ratios of urea breath test referrals were 4.6 and 9.0 (P < 0.0001) for general practitioners and gastroenterologists, respectively. Of the patients (n=230) with uninvestigated dyspepsia, who underwent urea breath testing according to a ‘test and treat’ strategy, 98 (42.6%) presented at least one risk factor for organic disease.Conclusions : In Italy, nearly 36% of urea breath test referrals are inappropriate or could be avoided if all dyspeptic patients with risk factors were referred for endoscopy or all dyspeptic patients undergoing endoscopy were tested for H. pylori infection with biopsy methods. Both general practitioners and, to a lesser extent, gastroenterologists require educational programmes to deal effectively with H. pylori.
Non‐transferrin‐bound iron in untreated and ribavirin‐treated chronic hepatitis C patients
Authors: Van Vlierberghe H. , Verdievel H. , Colle I. , Delanghe J. , Praet M. , Bernard D. , Leroux‐Roels G. , De Vos M. 
Published: March 2003

SummaryBackground : In patients with chronic hepatitis C, elevations in serum iron levels, hepatic iron content and oxidative stress‐related molecules have been reported. Treatment with ribavirin induces an increase in hepatic iron concentration. In situations of iron overload, non‐transferrin‐bound iron can appear. Therefore, we determined non‐transferrin‐bound iron levels in untreated chronic hepatitis C patients and in patients during interferon–ribavirin treatment.Materials and methods : In 10 untreated and 19 interferon–ribavirin‐treated chronic hepatitis C patients, we examined non‐transferrin‐bound iron levels by a colorimetric method using nitrilotriacetic acid as a ligand and sodium triscarbonatecobalt(iii) to block free iron binding sites on transferrin.Results : Despite the presence of high serum iron saturation and ferritin levels, non‐transferrin‐bound iron was absent in the majority of hepatitis C virus patients (25/29, 86%). There was no difference in non‐transferrin‐bound iron levels between untreated and treated patients. Four patients with high non‐transferrin‐bound iron levels were distinguished by higher serum iron levels. In two of these patients, hepatocytic iron was present on liver biopsy.Conclusions : In the majority of chronic hepatitis C patients, non‐transferrin‐bound iron levels are normal. Treatment with ribavirin does not induce high non‐transferrin‐bound iron levels. Non‐transferrin‐bound iron levels are only higher than normal in hepatitis C patients with higher serum iron levels.
A randomized placebo‐controlled trial of simethicone and cisapride for the treatment of patients with functional dyspepsia
Authors: Holtmann G. , Gschossmann J. , Mayr P. , Talley N. J. 
Published: March 2003

SUMMARYAim : To compare the efficacy of simethicone with placebo and the prokinetic cisapride in patients with functional dyspepsia.Methods : One hundred and eighty‐five patients with functional dyspepsia were randomized and treated in a double‐dummy technique with simethicone (105 mg t.d.s.), cisapride (10 mg t.d.s.) or placebo (t.d.s.). The primary outcome measure was the O'Brien global measure of the patients' rating of 10 upper gastrointestinal symptoms (graded as absent=0, moderate=1, severe=2 or very severe=3). Outcome measures were assessed at baseline and after 2, 4 and 8 weeks of treatment (intention‐to‐treat).Results : At 2, 4 and 8 weeks, treatment with simethicone and cisapride yielded significantly (all P values < 0.0001) better improvement of symptoms compared to placebo. Simethicone was significantly better than cisapride after 2 weeks (P=0.0007), but the differences were not statistically significant after 4 and 8 weeks. Patients treated with simethicone judged the efficacy of their treatment as very good in 46% of cases, compared to 15% and 16% receiving cisapride and placebo, respectively.Conclusions : Simethicone and cisapride were significantly better than placebo for symptom control in patients with functional dyspepsia after 2, 4 and 8 weeks of treatment. Simethicone was also superior to the prokinetic cisapride in the first 2 weeks of treatment.
Effects of ABT‐229, a motilin agonist, on acid reflux, oesophageal motility and gastric emptying in patients with gastro‐oesophageal reflux disease
Authors: Netzer P. , Schmitt B. , Inauen W. 
Published: March 2003

SummaryAim : The effect of ABT‐229, a new macrolide with no antibacterial activity, on gastro‐oesophageal reflux, oesophageal motility and gastric emptying in patients with gastro‐oesophageal reflux disease was investigated.Methods : Twenty‐one patients were treated with a placebo and ABT‐229 (2.5, 5 or 10 mg b.d.) in a randomized, incomplete crossover study design. Ambulatory 24‐h pH manometry was performed and gastric emptying was assessed by the 13C‐octanoic acid breath test on the seventh day of treatment.Results : A significant decrease was found in the mean (± s.e.) percentage of reflux time (intra‐oesophageal pH < 4) for ABT‐229 5 mg b.d. and 10 mg b.d., but not for 2.5 mg b.d., compared with placebo. For ABT‐229 5 mg, it was 8.5 ± 0.5% vs. 10.7 ± 0.7% (P < 0.038) and, for ABT‐229 10 mg, it was 6.6 ± 0.5% vs. 8.4 ± 0.5% (P < 0.019). There were no significant differences in any of the analysed manometric parameters. In addition, the gastric half‐emptying time for all doses of ABT‐229 did not differ significantly from that after placebo.Conclusions : ABT‐229 is able to reduce slightly, but significantly, acid reflux in patients with gastro‐oesophageal reflux disease. This effect does not appear to be due to a measurable improvement in oesophageal motility or gastric emptying.
Prokinetic effect of indoramin, an α‐adrenergic antagonist, on human gall‐bladder
Authors: Sengupta S. , Cooney R. , Baj M. , Ni'Muircheartaigh R. , O'Donnell L. J. D. 
Published: March 2003

SummaryBackground : The effects of α‐ and β‐adrenergic agents on gall‐bladder motility remain undefined.Aim : To determine the effects of α‐ and β‐antagonists on gall‐bladder motility in healthy humans.Methods : In this single, blind, three‐way crossover study, a slow‐release formulation of propranolol 80 mg (β‐antagonist), indoramin 25 mg (post‐synaptic α1‐antagonist) and placebo were administered to 10 healthy volunteers on three separate days 8 h before the assessment of gall‐bladder volumes by ultrasonography. Gall‐bladder volumes were assessed in the fasting state and at 5‐min intervals for 50 min after a standard proprietary enteral feed (Ensure 186 mL, Abbott).Results : The fasting gall‐bladder volumes of subjects who received placebo or indoramin were significantlydifferent (mean ± S.E.M.: 16.50 ± 2.78 mL and 13.47 ± 2.24 mL, respectively; P < 0.001, two‐way analysis of variance). The fasting gall‐bladder volume after the administration of propranolol was 17.49 ± 2.37 mL and was not significantly different from placebo (16.50 ± 2.78 mL). When the mean post‐prandial gall‐bladder volumes were compared, indoramin significantly enhanced post‐prandial gall‐bladder emptying compared to placebo (P < 0.001). There was no significant post‐prandial volume difference between placebo and propranolol.Conclusions : Indoramin, an α‐adrenergic antagonist, acts as a prokinetic agent, enhancing post‐prandial gall‐bladder emptying in healthy individuals.
Serum pepsinogen can predict response to H2‐receptor antagonist in patients with functional dyspepsia
Authors: Yoshikawa I. , Murata I. , Kume K. , Kanagawa K. , Hirohata Y. , Nakamura H. , Otsuki M. 
Published: March 2003

SummaryBackground : Therapy for the relief of symptoms of functional dyspepsia is unpredictable.Aim : To identify which patients may benefit from antisecretory therapy.Methods : Twenty‐seven patients with functional dyspepsia were selected to receive H2‐receptor antagonist (H2RA) treatment for 4 weeks. Serum pepsinogen A, pepsinogen C and gastrin were measured, and Helicobacter pylori status was determined. Symptoms were assessed at baseline and after H2RA treatment.Results : Fourteen patients were identified as H2RA responders and the remaining patients were non‐responders. No differences were found between responders and non‐responders with regard to serum pepsinogen A, pepsinogen C, gastrin and H. pylori status. However, the pepsinogen A/C ratio was significantly higher in responders than in non‐responders. Ten of the 13 functional dyspepsia patients (77%) with a high value of the pepsinogen A/C ratio (≥ 4.5) achieved symptom resolution by H2RA, compared with only one of the eight patients (13%) with a low value of the pepsinogen A/C ratio (≤ 3.0).Conclusions : The serum pepsinogen A/C ratio seems to identify those functional dyspepsia patients for whom acid control provides benefit. This ratio may be a practical tool for the management of functional dyspepsia patients.
Metabolic bone disease is present at diagnosis in patients with inflammatory bowel disease
Authors: Lamb E. J. , Wong T. , Smith D. J. , Simpson D. E. , Coakley A. J. , Moniz C. , Muller A. F. 
Published: March 2003

SummaryAim : To establish whether bone disease is present at diagnosis in inflammatory bowel disease and to identify contributory metabolic abnormalities.Methods : Newly diagnosed patients with inflammatory bowel disease (19 males, 15 females; mean age, 44 years; range, 17–79 years; 23 ulcerative colitis, 11 Crohn's disease) were compared against standard reference ranges and a control group with irritable bowel syndrome (eight males, 10 females; mean age, 40 years; range, 19–64 years). Bone mineral density (g/cm2, dual‐energy X‐ray absorptiometry: lumbar spine and femoral neck) and biochemical bone markers were measured.Results : Femoral neck bone mineral density, T‐ and Z‐scores (mean ± s.d., respectively) were lower in inflammatory bowel disease patients than in irritable bowel syndrome controls (0.78 ± 0.12 vs. 0.90 ± 0.16, P = 0.0046; − 0.88 ± 0.92 vs. 0.12 ± 1.17, P = 0.0018; − 0.30 ± 0.89 vs. 0.61 ± 1.10, P = 0.0030). Lumbar spine bone mineral density and T‐scores were also significantly lower in patients than controls (0.98 ± 0.15 vs. 1.08 ± 0.13, P = 0.0342; − 1.05 ± 1.39 vs. − 0.14 ± 1.19, P = 0.0304). Compared with controls, the urinary deoxypyridinoline : creatinine ratio was increased (7.66 vs. 5.70 nmol/mmol, P = 0.0163) and serum 25‐hydroxy vitamin D was decreased (18.7 vs. 28.5 µg/L, P = 0.0016); plasma osteocalcin and serum parathyroid hormone did not differ (P > 0.05).Conclusions : The bone mineral density is reduced at diagnosis, prior to corticosteroid treatment, in both Crohn's disease and ulcerative colitis. Our data suggest that this is attributable to increased resorption rather than decreased bone formation.
Breath testing for human liver function assessment
Authors: Armuzzi A. , Candelli M. , Zocco M. A. , Andreoli A. , De Lorenzo A. , Nista E. C. , Miele L. , Cremonini F. , Cazzato I. A. , Grieco A. , Gasbarrini G. , Gasbarrini A. 
Published: March 2003

SUMMARYCarbon‐labelled breath tests were proposed as tools for the evaluation of human liver function 30 years ago, but have never become part of clinical routine. One reason for this is the complex role of the liver in metabolic regulation, making it difficult to provide essential information for the management of patients with liver disease with a single test and to satisfy the hepatology community. As a result, a battery of breath tests have been developed. Depending on the test compound administered, different metabolic pathways (microsomal, cytosolic, mitochondrial) can be examined. Most available data come from microsomal function tests, whilst information about cytosolic and mitochondrial liver function is more limited. However, breath tests have shown promise in some studies, in particular to predict the outcome of patients with chronic liver disease or to monitor hepatic function after treatment. Whilst we await new substrates that can be used to measure liver function in a more valid manner, and large prospective studies to assess the usefulness of available test compounds, the aim of this review is to describe how far we have come in this controversial and unresolved issue.
Lipid‐induced colonic hypersensitivity in irritable bowel syndrome: the role of 5‐HT3 receptors
Authors: Simrén M. , Simms L. , D'Souza D. , Abrahamsson H. , Björnsson E. S. 
Published: March 2003

SummaryBackground : Irritable bowel syndrome patients demonstrate colonic hypersensitivity after duodenal lipid infusion.Aim : To investigate the role of 5‐hydroxytryptamine‐3 (5‐HT3) receptors in this sensory component of the gastrocolonic response in irritable bowel syndrome.Methods : Fifteen female patients with diarrhoea‐predominant irritable bowel syndrome completed a trial with the 5‐HT3 receptor antagonist alosetron (1 mg b.d.) or placebo (b.d.) over 15 days, followed by the alternative treatment. Each treatment period was followed by a colonic distension trial before and after duodenal lipids. Changes in colonic thresholds, tone and compliance and viscerosomatic referral pattern after lipids were compared between treatments.Results : With placebo, the colonic thresholds after lipids were significantly reduced for all studied sensations, whereas, with alosetron, the thresholds were significantly reduced only for first sensation and discomfort, but not for gas and pain. The reductions in thresholds did not differ significantly between treatments, but the pain threshold after alosetron tended to be less reduced compared with placebo (P = 0.10). The effects of lipids on tone, compliance and viscerosomatic referral pattern were unaffected by alosetron relative to placebo.Conclusions : 5‐HT3 receptor antagonism reduces the lipid‐induced colonic hypersensitivity in irritable bowel syndrome. However, 5‐HT3 receptors do not seem to be the principal mediator, but may be a cofactor for the exaggerated sensory component of the gastrocolonic response in irritable bowel syndrome.
Study of liver function in healthy elderly subjects using the 13C‐methacetin breath test
Authors: Ciccocioppo R. , Candelli M. , Di Francesco D. , Ciocca F. , Taglieri G. , Armuzzi A. , Gasbarrini G. , Gasbarrini A. 
Published: March 2003

SummaryBackground : The issue of whether or not liver function is compromised in the healthy elderly population remains unsolved.Aim : To investigate the putative age‐related modifications of hepatic function using the 13C‐methacetin breath test. Because endogenous CO2 production changes with age, motor activity and nutrition, a different form of processing the results was investigated.Patients and methods :
Twenty‐nine elderly subjects (mean age, 79.8 ± 7.9 years; female/male ratio, 17/12) and 28 adult subjects (mean age, 40.6 ± 12.3 years; female/male ratio, 13/15) underwent
13 C‐methacetin breath test and trans‐abdominal echosonography with Doppler pulsed wave analysis of the coeliac axis and portal vein.Results : Although the 13CO2 peak occurred within 15–30 min in both elderly and adult subjects, it was significantly decreased in the former (30.66% ± 9.2% vs. 38.33% ± 6.05%; P < 0.001), as was the cumulative excretion (33.07% ± 7.06% vs. 39.81% ± 5.68%; P < 0.001). When correcting for the effects of CO2 excretion by age, the age‐related modification of the cumulative dose became more evident (elderly group 30.15% ± 6.46% vs. adult group 37.97% ± 5.92%; P < 0.0001). The elderly group also showed an increase in the intra‐hepatic resistance index using Doppler pulsed wave analysis, which inversely correlated with the results of the breath test.Conclusions : Hepatic function is not well preserved in healthy humans throughout life and may be due to an increase in vascular resistance.
Retained common bile duct stones: a comparison between biliary stenting and complete clearance of stones by electrohydraulic lithotripsy
Authors: Hui C.‐K. , Lai K.‐C. , Ng M. , Wong W.‐M. , Yuen M.‐F. , Lam S.‐K. , Lai C.‐L. , Wong B.C.Y. 
Published: March 2003

SummaryBackground : There is some uncertainty as to whether high‐risk patients with difficult common bile duct stones should be subjected to a further endoscopic procedure for the complete removal of stones by electrohydraulic lithotripsy or whether permanent biliary stenting should be performed.Aim : To compare the outcome of permanent biliary stenting with electrohydraulic lithotripsy in this group of patients.Methods : In a prospective study, 36 patients with difficult common bile duct stones were investigated: 19 underwent double pigtail insertion (stent group), whereas 17 underwent complete clearance of stones (electrohydraulic lithotripsy).Results : In the electrohydraulic lithotripsy group, successful stone clearance was achieved in 76.5%, whereas, in the stent group, the success of stenting was 94.7%. A significant difference was detected in the actuarial incidence of recurrent acute cholangitis when the electrohydraulic lithotripsy group was compared with the stent group [one patient (7.7%) vs. 12 patients (63.2%), respectively; P = 0.002, log rank test]. A significant difference was detected in the actuarial frequency of mortality between the electrohydraulic lithotripsy and stent groups [seven patients (41.2%) vs. 14 patients (73.7%), respectively; P = 0.01, log rank test].Conclusions : The removal of difficult common bile duct stones by electrohydraulic lithotripsy and further endoscopic retrograde cholangiopancreatography has a high success rate and a low complication rate even in the elderly.
Symptomatic response to lansoprazole predicts abnormal acid reflux in endoscopy‐negative patients with non‐cardiac chest pain
Authors: Xia H. H. X. , Lai K. C. , Lam S. K. , Hu W. H. C. , Wong N. Y. H. , Hui W. M. , Lau C. P. , Chen W. H. , Chan C. K. , Wong W. M. , Wong B. C. Y. 
Published: March 2003

SummaryAim : To determine whether symptomatic response to lansoprazole predicts abnormal acid reflux in endoscopy‐negative patients with non‐cardiac chest pain.Methods : Patients who complained of chest pain, but had normal coronary angiography, were asked to undergo upper endoscopy. Those without gastric and oesophageal lesions were recruited for 24‐h ambulatory oesophageal pH monitoring, and were randomly given lansoprazole 30 mg or placebo, both daily for 4 weeks. Chest pain symptoms were recorded before and 1 month after treatment on a locally validated questionnaire. The symptom score was calculated by multiplying the severity and frequency of the symptom, and symptom improvement was defined as > 50% reduction in symptom score.Results : Overall, 68 patients, 36 on lansoprazole and 32 on placebo, completed the trial. The symptom score was reduced significantly in both groups (P < 0.001). In the lansoprazole group, more patients with than without abnormal reflux showed symptom improvement (92% vs. 33%; odds ratio = 22; 95% confidence interval, 2.3–201.8; χ2 = 10.9; P = 0.001), giving a sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 92%, 67%, 58%, 94% and 75%, respectively. In the placebo group, the rates of symptom improvement were similar between those with and without abnormal reflux (33% vs. 35%, P = N.S.).Conclusions : Treatment with lansoprazole is a useful test in diagnosing endoscopy‐negative gastro‐oesophageal reflux disease in Chinese patients with non‐cardiac chest pain.