bluuebunny/crossref_metadata_2025_split huggingface dataset:
A multicentre study on eradication of Helicobacter pylori using four 1‐week triple therapies in China
Authors:   CHINESE NATIONAL COOPERATIVE STUDY GROUP FOR HELICOBACTER PYLORI, Xiao S.‐D. , Liu W.‐Z. , Hu P.‐J. , Ouyang Q. , Wang J.‐L. , Zhou L.‐Y. , Cheng N.‐N. 
Published: March 2003

Background:Short‐term proton pump inhibitor‐based triple therapies for the eradication of Helicobacter pylori are used widely. The eradication rates vary greatly from country to country and from region to region.Aim:To assess the efficacy at eradicating H. pylori of 1‐week regimens containing three medications: omeprazole (O) or colloidal bismuth subcitrate (B), furazolidone (F) or metronidazole (M), and amoxicillin (A) or clarithromycin (C).Methods:A multicentre study involving 20 hospitals in different regions of China. A total of 892 patients with H. pylori‐positive non‐ulcer dyspepsia or healed duodenal ulcer confirmed by endoscopy were recruited to receive, randomly, one of four regimens: OMC, OFC, OFA, and BFC, b.d. for 7 days. 13C‐urea breath test was performed 4–8 weeks after completion of treatment.Results:The eradication rates with per protocol/intention‐to‐treat analyses were: OMC (n=217/219) 66%/65%; OFC (n=227/229) 69%/69%; OFA (n=223/225) 87%/86%; and BFC (n=214/219) 80%/78%. The eradication rate (per protocol analysis) in duodenal ulcer (79%) was higher than that in non‐ulcer dyspepsia (73%, P=0.033). Patient compliance was good. The adverse events of the four regimens were mild, and mainly gastrointestinal.Conclusions:The omeprazole, furazolidine and amoxicillin regimen achieves a high H. pylori eradication rate in different geographical regions of China.
Iron and inflammatory bowel disease
Authors: Oldenburg B. , Koningsberger J. C. , Van Berge Henegouwen G. P. , Van Asbeck B. S. , Marx J. J. M. 
Published: March 2003

Both anaemia of iron deficiency and anaemia of chronic disease are frequently encountered in inflammatory bowel disease. Anaemia of iron deficiency is mostly due to inadequate intake or loss of iron. Anaemia of chronic disease probably results from decreased erythropoiesis, secondary to increased levels of proinflammatory cytokines, reactive oxygen metabolites and nitric oxide.Assessment of the iron status in a condition associated with inflammation, such as inflammatory bowel disease, is difficult. The combination of serum transferrin receptor with ferritin concentrations, however, allows a reliable assessment of the iron deficit.The best treatment for anaemia of chronic disease is the cure of the underlying disease. Erythropoietin reportedly may increase haemoglobin levels in some of these patients. The anaemia of iron deficiency is usually treated with oral iron supplements. Iron supplementation may lead to an increased inflammatory activity through the generation of reactive oxygen species. To date, data from studies in animal models of inflammatory bowel disease support the theoretical disadvantage of iron supplementation in this respect. The results, however, cannot easily be extrapolated to the human situation, because the amount of supplemented iron in these experiments was much higher than the dose used in patients with iron deficiency.
Octreotide 24‐h prophylaxis in patients at high risk for post‐ERCP pancreatitis: results of a multicenter, randomized, controlled trial
Authors: Testoni P. A. , Bagnolo F. , Andriulli A. , Bernasconi G. , Crotta S. , Lella F. , Lomazzi A. , Minoli G. , Natale C. , Prada A. , Toti G. L. , Zambelli A. 
Published: March 2003

Background:Pharmacological prophylaxis of post‐ERCP pancreatitis is costly and not useful in most non‐selected patients, in whom the incidence of pancreatitis is 5% or less. However, it could be useful and probably cost‐effective, in patients at high risk for this complication, where the post‐procedure pancreatitis rate is 10% and more.Aim:To assess the efficacy of octreotide in reducing the incidence and severity of post‐ERCP pancreatitis and procedure‐related hospital stay, in subjects with known patient‐related risk factors.Methods:A total of 120 patients were randomly allocated to receive octreotide or not, in a multicentre, randomized, controlled trial. The drug was given subcutaneously, 200 μg t.d.s., starting 24 h before the ERCP procedure, in patients with either sphincter of Oddi dysfunction, or a history of relapsing pancreatitis or post‐ERCP pancreatitis, or who were aged under 35 years, or who had a small common bile duct diameter (< 8 mm).Results:A total of 114 patients (58 in the octreotide group and 56 in the control group) completed the trial. Post‐procedure pancreatitis occurred in seven octreotide‐treated patients (12.0%) and eight controls (14.3%). The two groups showed no significant differences in the incidence or severity of pancreatitis. Twenty‐four hours after the procedure, severe hyperamylasemia (more than five times the upper normal limit) without pancreatic‐like pain was recorded in three octreotide‐treated patients (5.2%) and six controls (10.7%), the difference being not significant.Conclusion:Twenty‐four‐hour prophylaxis with octreotide proved ineffective in preventing post‐ERCP pancreatitis and in avoiding 24‐h severe hyperamylasemia in high‐risk patients.
Safety and efficacy of azathioprine in the maintenance of ciclosporin‐induced remission of ulcerative colitis
Authors: Actis G. C. , Bresso F. , Astegiano M. , Demarchi B. , Sapone N. , Boscaglia C. , Rizzetto M. 
Published: March 2003

Background:It has been shown that azathioprine prolongs the response to ciclosporin of steroid‐refractory ulcerative colitis, but no specific data are available concerning its toxicity in this indication.Aim and methods:The charts of 21 patients with steroid‐refractory ulcerative colitis who received azathioprine overlapping with a successful ciclosporin course were reviewed for the onset of toxicity. The controls consisted of 48 initial responders to steroids who received azathioprine for steroid‐dependence or resistance/toxicity.Results:Two of the 21 patients were withdrawn because of hypersensitivity to azathioprine. The remaining 19 were treated for a median of 18 months together with a median daily steroid dose of 35 mg (10–75 mg) to be tapered off. Toxicity (31%) included leukopenia alone (two cases), cholestasis alone (one case), cholestasis and increased amylase (one case), increased amylase alone (one case), and cutaneous infection (one case). The frequency of withdrawal was 21%. The mean daily steroid doses were reduced from 38 mg to 3.8 mg in the study cohort, and from 25 mg to 8 mg in the controls, among whom toxicity (27%) included four cases each of leukopenia and increased amylase, two cases each of alteration of liver enzymes and infection, and one case of gastric intolerance. Ten of the 48 controls (20%) were withdrawn from the study.Conclusion:Azathioprine is as effective and safe in the maintenance of the response of patients with steroid‐refractory ulcerative colitis to ciclosporin as it is in the treatment of those who respond to steroids.
A triple therapy regimen after failed Helicobacter pylori treatments
Authors: Zullo A. , Hassan C. , Campo S. M. A. , Lorenzetti R. , Febbraro I. , De Matthaeis M. , Porto D. , Morini S. 
Published: March 2003

Background: Following standard triple therapy, up to 20% of patients require further Helicobacter pylori eradication treatment. Data regarding the efficacy of re‐treatment in these patients are scarce.Aim: To evaluate the efficacy of a triple therapy after one or more consecutive treatment failures.Methods: A total of 51 patients with persistent H. pylori infection after at least one unsuccessful standard 1‐week regimen were enrolled in the study. H. pylori infection at entry was assessed by rapid urease test and histology on biopsies from the antrum and the corpus. Patients were given a 2‐week triple therapy, comprising ranitidine bismuth citrate 400 mg b.d., tetracycline 500 mg t.d.s., and tinidazole 500 mg b.d. Ranitidine bismuth citrate was given during meals, whilst tetracycline and tinidazole was given after meals. Bacterial eradication was assessed by endoscopy (36 patients) or 13C‐urea breath test (15 patients) 4–6 weeks after therapy had ended.Results: All 51 patients completed the study and H. pylori eradication was achieved in 46, with an eradication rate of 90% (95% CI: 82–98). In detail, bacterial eradication was obtained in 96% of patients who had previously failed one course of clarithromycin–amoxicillin based triple therapy, in 88% patients who had failed a clarithromycin–tinidazole based triple therapy, in 83% patients who had failed both treatment schedules, and in the only patient who had failed three consecutive therapeutic attempts. Two patients took the therapy for 9 and 10 days instead of the full 14 day‐course. No major side‐effects were reported, whilst six (12%) patients complained of mild side‐effects.Conclusion: This study demonstrates that this triple therapy regimen is effective for re‐treatment of H. pylori infection.
Glucocorticoids and IL‐10, but not 6‐MP, 5‐ASA or sulfasalazine block endothelial expression of MAdCAM‐1: implications for inflammatory bowel disease therapy
Authors: Oshima T. , Pavlick K. , Grisham M. B. , Jordan P. , Manas K. , Joh T. , Itoh M. , Alexander J. S. 
Published: March 2003

Background: Enhanced MAdCAM‐1 (mucosal addressin cell adhesion molecule‐1) expression is associated with the aetiology of inflammatory bowel disease, but little is known about MAdCAM‐1: regulation, or how inflammatory bowel disease therapies modulate MAdCAM‐1.Aim: To examine how agents currently used to treat inflammatory bowel disease affect MAdCAM‐1: induced by tnf‐α in an in vitro model of inflammatory bowel disease.Methods: Endothelial monolayers were pretreated with dexamethasone (DEX): 5‐aminosalicylic acid (5‐ASA), 6‐mercaptopurine (6‐MP), sulfasalazine or interleukin‐10: (IL‐10: prior to TNF‐α (20 ng/mL), and MAdCAM‐1: measured by Western blotting, RT‐PCR, EMSA and lymphocyte adhesion assays.Results: MAdCAM‐1: was induced dose‐ and time‐dependently by TNF‐α on endothelial cells. Either dexamethasone or IL‐10: reduced TNF‐α‐induced MAdCAM‐1: protein, mRNA and lymphocyte adhesion. However, neither 5‐ASA, sulfasalazine nor 6‐MP blocked MAdCAM‐1 induction.Conclusions: Our data indicate that dexamethasone or IL‐10 can exert therapeutic activity in inflammatory bowel disease through MAdCAM‐1 inhibition. 5‐ASA, sulfasalazine and 6‐MP, while beneficial in inflammatory bowel disease, do not directly control MAdCAM‐1, and are beneficial through inhibition of other inflammatory processes.
Bedtime H2 blockers improve nocturnal gastric acid control in GERD patients on proton pump inhibitors
Authors: Xue S. , Katz P. O. , Banerjee P. , Tutuian R. , Castell D. O. 
Published: March 2003

Aim:Proton pump inhibitors taken twice daily before meals (proton pump inhibitor b.d. AC) effectively controls daytime gastric pH; however, nocturnal gastric acid breakthrough (NAB) occurs in more than 75% of patients. Adding an H2‐blocker at bedtime decreases NAB in normal subjects. The efficacy of this regimen has not been evaluated in GERD patients. The aim of this study was to assess the effects of proton pump inhibitor b.d., both with and without bedtime H2‐blocker on intragastric pH and the occurrence of NAB in GERD patients.Methods:Prolonged ambulatory pH studies in GERD patients were reviewed. Group A: 60 patients (mean age 53 years, male 30) taking either omeprazole 20 mg or lansoprazole 30 mg b.d. Group B: 45 patients (mean age 49 years, male 23) on proton pump inhibitor b.d. (omeprazole 20 mg or lansoprazole 30 mg) plus an H2‐blocker at bedtime (ranitidine 300 mg, famotidine 40 mg or nizatidine 300 mg). Eleven patients were evaluated during treatment with both regimens (group C). The percentage time of nocturnal and daytime intragastric pH > 4 and per cent of patients with gastric NAB were analysed. In the patients with NAB, its duration and associated oesophageal acid exposure also were analysed.Results:Median percentage time intragastric pH > 4 overnight was 51% in group A, compared to 96% in group B (P < 0.0001). Median percentage daytime pH > 4 was 73% in group A and 79.8% in group B (P=0.14). Median percentage time intragastric pH >p 4 overnight increased from 54.6% without H2RA to 96.5% after adding bedtime H2RA (P=0.0013) in group C patients. NAB occurred in 82% patients in group A and 40% in group B (P < 0.0001). The mean duration of oesophageal acid exposure during NAB was significantly shorter in group B (18 ± 6 min) than in group A (42 ± 9 min, P=0.04).Summary:Adding a bedtime H2‐blocker to the treatment enhanced nocturnal gastric pH control and decreased NAB compared to the proton pump inhibitor b.d. regimen. A bedtime H2‐blocker also decreased oesophageal acid exposure during NAB.Conclusion:Adding a bedtime H2‐blocker to a proton pump inhibitor b.d. regimen should be considered in patients who require continued nocturnal gastric acid control whilst taking proton pump inhibitor b.d.
Extracorporeal photochemotherapy in patients with steroid‐dependent Crohn’s disease: a prospective pilot study
Authors: Reinisch W. , Nahavandi H. , Santella R. , Zhang Y. , Gasché C. , Moser G. , Waldhör T. , Gangl A. , Vogelsang H. , Knobler R. 
Published: March 2003

Background:Extracorporeal photochemotherapy has been proven effective in selected T‐cell mediated diseases.Aim:To evaluate the safety and efficacy of extracorporeal photochemotherapy in patients with steroid‐dependent Crohn’s disease by an open, monocentric trial in three phases of 24 weeks each.Methods:In phase 1 standardized steroid tapering was initiated in patients with a history of steroid‐dependent Crohn’s disease. Those with a prospectively evaluated maintenance dose of at least 10 mg/day prednisolone continued steroid‐withdrawal under the application of extracorporeal photochemotherapy in phase 2. The duration of remission or response was followed during phase 3. Colonic tissue bioptically obtained before and after extracorporeal photochemotherapy was studied by immunofluorescence microscopy for the presence of photoadduct positive cells.Results:Out of 24 patients included in phase 1, 10 entered phase 2 for extracorporeal photochemotherapy. Four subjects achieved remission and four others response. Significant reductions in serum C‐reactive protein levels and intestinal permeability were measured, as well as increases in quality of life and plasma adrenocorticotropic hormone levels. No major side‐effects were observed. Remission remained stable in three out of four patients during phase 3. In three patients, positive nuclear stainings of photoadducts were detected in colonic mononuclear cells after extracorporeal photochemotherapy.Conclusions:Extracorporeal photochemotherapy represents a safe steroid‐sparing approach in patients with Crohn’s disease and is associated with intestinal homing of photopheresed cells.
Helicobacter pylori antimicrobial resistance in the United Kingdom: the effect of age, sex and socio‐economic status
Authors: Parsons H. K. , Carter M. J. , Sanders D. S. , Winstanley T. , Lobo A. J. 
Published: March 2003

Background: Helicobacter pylori antimicrobial resistance is the most common reason for eradication failure. Small studies have shown metronidazole resistance to be more prevalent in certain population groups.Aim:To determine the resistance rates in a large cohort of patients from a single centre in the UK, and to evaluate resistance patterns over time, according to age, sex and socio‐economic status.Methods:Consecutive patients with H. pylori‐positive antral gastric biopsy samples were studied from 1994 to 1999. Susceptibility testing was performed to metronidazole, tetracycline, macrolide and amoxicillin by the modified disk diffusion method. The Jarman under‐privileged area score was used as a measure of socio‐economic status.Results:A total of 1064 patients were studied. Overall metronidazole resistance was 40.3%, decreasing with age (P < 0.0001, odds ratio for patients over 60 years 0.63, 95% CI: 0.48–0.80). Women were more likely to have metronidazole resistant strains (P=0.003, odds ratio 1.5, 95% CI: 1.15–1.91), but there was no association with Jarman score. Macrolide resistance was associated with metronidazole resistance (P=0.03, odds ratio 2.14, 95% CI: 1.07–4.28).Conclusions:Metronidazole resistance in H. pylori is highly prevalent and more common in women and the young, but does not appear to be related to socio‐economic status.
A comparison of simplified lansoprazole suspension administered nasogastrically and pantoprazole administered intravenously: effects on 24‐h intragastric pH
Authors: Täubel J. J. , Sharma V. K. , Chiu Y. L. , Lukasik N. L. , Pilmer B. L. , Pan W. J. 
Published: March 2003

Aim:To compare the 24‐h intragastric pH effects of simplified lansoprazole suspension, 30 mg, administered nasogastrically, with pantoprazole, 40 mg, administered intravenously.Methods:Thirty‐six healthy adults were enrolled and given simplified lansoprazole suspension, 30 mg (nasogastrically), or pantoprazole, 40 mg (intravenously), once daily for five consecutive days in a cross‐over fashion. Intragastric pH was monitored at baseline and on Days 1 and 5 of each treatment period. The pharmacokinetic parameters of lansoprazole and pantoprazole were also determined on Days 1 and 5.Results:No statistically significant changes in pharmacokinetic parameters occurred between Days 1 and 5 with either regimen, except for pantoprazole Cmax. On Days 1 and 5, significantly higher mean 24‐h intragastric pH values were observed with 30 mg simplified lansoprazole suspension compared with 40 mg intravenous pantoprazole (Day 1, 3.13 vs. 2.67; Day 5, 3.95 vs. 3.61, respectively; P < 0.05). Additionally, 30 mg simplified lansoprazole suspension produced significantly (P < 0.05) higher percentages of time intragastric pH was above 3, 4, 5 or 6 as compared with 40 mg intravenous pantoprazole throughout Days 1 and 5.Conclusions:A 30 mg dose of simplified lansoprazole suspension administered nasogastrically was consistently more effective at controlling intragastric pH than pantoprazole, 40 mg, administered intravenously.
Nizatidine and cisapride enhance salivary secretion in humans
Authors: Adachi K. , Ono M. , Kawamura A. , Yuki M. , Fujishiro H. , Kinoshita Y. 
Published: March 2003

Background:Salivation plays an important role in the defence of the oesophageal mucosa against gastric acidic reflux and can be evoked by cholinergic stimulation. Both nizatidine and cisapride have been reported to increase acetylcholine concentrations in the cholinergic system.Aim:To investigate the effect of nizatidine and cisapride on salivary secretion, salivary epidermal growth factor and bicarbonate output.Methods:The salivary volume and concentration of salivary epidermal growth factor and bicarbonate were measured after the administration of nizatidine (150 mg), famotidine (20 mg) and cisapride (5 mg) in 30 male healthy volunteers.Results:Basal and stimulated salivary secretions were found to be increased after the administration of nizatidine and cisapride. In contrast, salivary secretion was not increased by famotidine. Although epidermal growth factor content was not augmented, nizatidine and cisapride administration also increased the bicarbonate output in mastication‐stimulated saliva.Conclusions:Increased salivary secretion and bicarbonate output induced by nizatidine may be useful for the treatment of patients with gastro‐oesophageal reflux disease.
Antibiotic prophylaxis prior to endoscopic retrograde cholangiopancreatography in patients with obstructive jaundice: is it worth the cost?
Authors: Thompson B. F. , Arguedas M. R. , Wilcox C. M. 
Published: March 2003

Background:There are few published data concerning the economic impact of antibiotic prophylaxis prior to endoscopic retrograde cholangiopancreatography in the setting of biliary obstruction.Aim:To perform decision analysis to determine the costs of prophylaxis in patients undergoing endoscopic retrograde cholangiopancreatography for obstructive jaundice.Methods:A decision analysis model was constructed. The probability of biliary sepsis, death and endoscopic retrograde cholangiopancreatography complications was obtained from the medical literature and from a retrospective analysis of our own experience. Costs were obtained from Medicare reimbursement at our institution. The strategies evaluated were endoscopic retrograde cholangiopancreatography with and without single‐dose antibiotic prophylaxis. We compared the total costs, number of episodes of cholangitis and deaths associated with each strategy.Results:Based on published data and the results of our retrospective analysis, the strategy of administering single‐dose prophylactic antibiotics prior to endoscopic retrograde cholangiopancreatography in patients with obstructive jaundice resulted in lower total costs, fewer episodes of cholangitis and fewer deaths compared to a strategy of not administering antibiotics. The results were sensitive to the rates of cholangitis, cost of antibiotics and the cost of treating an episode of cholangitis.Conclusions:Antibiotic prophylaxis prior to endoscopic retrograde cholangiopancreatography results in fewer cases of cholangitis and is cost saving when compared to a strategy of no prophylaxis in patients with obstructive jaundice.
Specific identification of three low molecular weight membrane‐associated antigens of Helicobacter pylori
Authors: Voland P. , Weeks D. L. , Vaira D. , Prinz C. , Sachs G. 
Published: March 2003

Background:A large number of Helicobacter pylori proteins are antigenic, but antibodies to these proteins persist in spite of the eradication of the infection.Methods and results:The analysis of sera from H. pylori‐infected and non‐infected patients, before and 3 and 5 months after eradication, showed that the antibody response against unknown H. pylori antigens at 32, 30, 22 and 14 kDa in sodium dodecylsulphate polyacrylamide gel electrophoresis decreased by ≥ 60% at 3 months and ≥ 70% at 5 months after treatment. Two‐dimensional gel electrophoresis and mass spectrometry allowed the identification of eight proteins at these positions: neuraminyl‐lactose‐binding haemagglutinin precursor, 3‐oxoadipate CoA‐transferase subunit A, elongation factor P, peptidoglycan‐associated lipoprotein precursor, hypothetical protein HP0596, adhesin‐thiol peroxidase, 50S ribosomal protein L7/L12 and subunit b′ of the F0 ATP synthase. Three of these eight, expressed as recombinant proteins (32 kDa neuraminyl‐lactose‐binding haemagglutinin precursor, 30 kDa peptidoglycan‐associated lipoprotein precursor and 22 kDa hypothetical protein HP0596), reacted specifically with sera from infected patients, while the 14 kDa 50S ribosomal protein L7/L12 cross‐reacted with one out of five sera from H. pylori‐negative patients. The other recombinant proteins did not show significant immunoreactivity.Conclusions:Four low molecular weight antigens were identified by these methods, three of which were specific. Immunoreaction with these three proteins (neuraminyl‐lactose‐binding haemagglutinin precursor, peptidoglycan‐associated lipoprotein precursor and hypothetical protein HP0596) could provide a serological assessment not only of H. pylori infection, but also of eradication.