bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cellular digital fibromas: distinctive CD34‐positive lesions that may mimic dermatofibrosarcoma protuberans
Authors: McNiff Jennifer M. , Subtil Antonio , Cowper Shawn E. , Lazova Rossitza , Glusac Earl J. 
Published: June 2005

Background:  Digital fibromas are common benign acral tumors typically reported as angiofibromas (AFs) or acquired digital fibrokeratomas (ADFs). Cellular variants are not well recognized.Methods:  We collected 14 acral fibrocytic lesions showing a spindle cell morphology from our files, and evaluated CD34, Factor XIIIa, epithelial membrane antigen (EMA), and S100 protein staining of these lesions. We compared the histologic and immunohistochemical features of these cellular fibromas with five digital AFs, five ADFs, and five digital dermatofibromas.Results:  The 14 cellular digital fibromas showed intersecting fascicles of thin delicate bland spindle cells in the superficial reticular dermis with a fibrotic‐to‐slight myxoid stroma. The spindle cells in all cases stained strongly for CD34, and only scattered stromal cells stained for Factor XIIIa. Five tested cases were negative for EMA and S100 protein. The digital AFs, fibrokeratomas, and dermatofibromas stained predominately for Factor XIIIa, with no or minimal staining for CD34.Conclusions:  These findings suggest that a subset of digital fibromas is characterized by a dense cellular proliferation of CD34‐positive spindle cells. Awareness of this variant of digital fibroma and its staining pattern is critical in preventing misdiagnosis as dermatofibrosarcoma protuberans, particularly in superficial biopsies.
Candida albicans‐specific lymphoproliferative and cytokine (IL‐4 and IFN‐γ) responses in atopic eczema dermatitis syndrome. Evidence of CD4/CD8 and CD3/CD16+CD56 ratio elevations in vitro
Authors: Kosonen Jan , Luhtala Marko , Viander Markku , Kalimo Kirsti , Terho Erkki O. , Savolainen Johannes 
Published: June 2005

Background:  Hypersensitivity to cross‐reactive mannan polysaccharide allergens of saprophytic yeasts is likely to be involved in the pathogenesis of atopic eczema dermatitis syndrome (AEDS). Mannans induce elevated specific immunoglobulin E and lymphoproliferative responses in peripheral blood mononuclear cells (PBMCs). To gain more detailed data of the involvement of different subpopulations of PBMCs in AEDS after mannan stimulation, changes in the cell‐surface marker distribution were analysed.Methods:  The Ficoll‐isolated PBMCs of eight yeast hypersensitive AEDS patients and seven non‐AEDS controls were stimulated in vitro by mannan (CAM) or whole extract antigen [In‐House Reference (IHR)] of Candida albicans or tuberculin [purified protein derivative (PPD)] and after immunofluorescence staining analysed by flow cytometry. The expression of cytokine mRNA was measured by kinetic real‐time polymerase chain reaction (TaqMan®).Results:  After 7‐day antigen stimulation, there were significant increases in the CD3/CD16+CD56 ratio (P = 0.028 with mannan and P = 0.006 with IHR), CD4/CD8 ratio (P = 0.049 with mannan) and interleukin‐4/interferon‐γ (IL‐4/IFN‐γ) mRNA ratio (P = 0.028 with IHR) and a decrease in the CD3/CD19 ratio (P = 0.035 with mannan) of AEDS patients' PBMCs as compared with healthy controls' cells. These changes were not seen in cultures with PPD.Conclusions:  The observed CAM and IHR‐induced elevations in T cell/natural killer cell, CD4/CD8 and IL‐4/IFN‐γ ratios suggest that C. albicans‐induced TH2‐type responses can also play a role in AEDS.
Meta‐analysis: role of Helicobacter pylori eradication in the prevention of peptic ulcer in NSAID users
Authors: Vergara M. , Catalán M. , Gisbert J. P. , Calvet X. 
Published: June 2005

SummaryAim : To evaluate whether eradication of Helicobacter pylori prevents peptic ulcer in non‐steroidal anti‐inflammatory drug users by means of a meta‐analysis.Material and methods : A systematic search was performed in MEDLINE, EMBASE, the Cochrane Controlled Trials Register and the AGA congress. Randomized trials comparing H. pylori eradication vs. non‐eradication or eradication vs. a proton pump inhibitor in patients receiving a non‐steroidal anti‐inflammatory drug were selected.Results : Five studies and 939 patients were included in the analysis; 34 of 459 (7.4%) patients developed a peptic ulcer in the eradicated group vs. 64 of 480 (13.3%) in the control group. The odds ratio was 0.43 (95% confidence interval: 0.20–0.93). Sub‐analyses showed a significant reduction of risk for non‐steroidal anti‐inflammatory drug‐naive (odds ratio = 0.26; 95% confidence interval: 0.14–0.49) but not for previously treated patients (odds ratio = 0.95, 95% confidence interval: 0.53–1.72). Two studies with a total of 385 patients compared eradication vs. a proton pump inhibitor; five of 196 (2.6%) developed a peptic ulcer in the eradicated group vs. zero of 189 (0%) in the proton pump inhibitor group (odds ratio = 7.43; 95% confidence interval: 1.27–43.6).Conclusion : Helicobacter pylori eradication reduces the incidence of peptic ulcer in the overall population receiving non‐steroidal anti‐inflammatory drugs. It appears to be especially effective when performed in non‐steroidal anti‐inflammatory drug‐naïve patients. Nonetheless, eradication seems less effective than treatment with a maintenance proton pump inhibitor for preventing non‐steroidal anti‐inflammatory drug‐associated ulcers.
Gastro‐oesophageal reflux is more prevalent in Western dyspeptics: a prospective comparison of British and South‐East Asian patients with dyspepsia
Authors: Mahadeva S. , Raman M. C. , Ford A. C. , Follows M. , Axon A. T. R. , Goh K.‐L. , Moayyedi P. 
Published: June 2005

SummaryBackground : There is a paucity of data directly comparing dyspepsia in Western and Eastern populations.Aim : To compare clinical symptoms, epidemiological factors and endoscopic diagnoses in two sample populations with dyspepsia from the United Kingdom and South‐East Asia in a cross‐sectional study.Methods : Patients with uncomplicated dyspepsia attending endoscopy units in Leeds, UK, and Kuala Lumpur, Malaysia, were prospectively interviewed and underwent subsequent endoscopy.Results : A total of 1003 Malaysian patients (January 2002 to August 2003) and 597 Caucasian British patients (January 2000 to October 2002) were studied. The mean age was 48.7 ± 15.8 and 47.5 ± 13.8 years for the Malaysian and British patients respectively (P = NS). There was a higher proportion of cigarette smoking (35.7% vs. 12.4%, P < 0.0001) and alcohol consumption (34.4% vs. 2.0%, P < 0.0001) amongst British patients, but no difference in non‐steroidal anti‐inflammatory drug use nor having Helicobacter pylori infection. Gastro‐oesophageal reflux disease (GERD) symptoms were more common in British compared with South‐East Asian patients [heartburn (72% vs. 41%), regurgitation (66% vs. 29.8%) and dysphagia (21.1% vs. 7.3%), P < 0.0001]. This correlated with an increased endoscopic finding of oesophagitis (26.8% vs. 5.8%) and columnar‐lined oesophagus (4.4% vs. 0.9%) amongst British patients (P < 0.001). A logistic regression model revealed that British Caucasian race (OR 9.7; 95% CI = 5.0–18.8), male gender (OR 2.0; 95% CI = 1.4–2.9) and not having H. pylori infection (OR 0.5; 95% CI = 0.3–0.7) were independent predictors for oesophagitis.Conclusion : GERD is more common in British compared with South‐East Asian dyspeptic patients suggesting that race and/or western lifestyle are important risk factors.
Long‐term healing of Crohn's anal fistulas with fibrin glue injection
Authors: Vitton V. , Gasmi M. , Barthet M. , Desjeux A. , Orsoni P. , Grimaud J. C. 
Published: June 2005

SummaryBackground : Injecting fibrin glue has proved to be an effective means of treating anal fistulas (AF). There has been some debate, however, as to whether this technique should be used on the AF often involved in Crohn's disease (CD).Aim : To assess the effectiveness of injecting heterologous fibrin glue as a means of treating AF refractory to immunosuppressive treatment in patients with CD.Methods : Fourteen CD patients (five men and nine women, average age 42 years) presenting with refractory AFs were included in this study. Heterologous fibrin glue was injected into the fistula tract under general anaesthesia under continuous endosonographic monitoring using a 7.5‐MHz blind linear probe. The patients were followed up clinically and ultrasonographically for 3 months after the procedure, and then at regular intervals.Results : Three months after the fibrin glue injection, the fistulas had completely dried up in 10 patients (71%), the leakage had decreased in one patient (7%), and no improvement was observed in the other three patients (21%). Endosonographic findings showed that the fistula tract had completely disappeared in two cases (14%). The fistula tract was found to be non‐permeable in eight cases (57%), and no change in the fistula was observed in four patients (29%). At the end of the follow‐up period [average 23.4 months (12–26 months)], the leakage had completely dried up in eight of the 14 patients (57%). No side effects were observed.Conclusion : Nearly 2 years after the use of a heterologous fibrin glue to treat an AF, over half of the patients with CD showed clinical signs of remission. Because it is easy to use and harmless as well as being effective, this method provides a good alternative to classical methods of surgical treatment.
Personal view: food for thought – western lifestyle and susceptibility to Crohn's disease. The FODMAP hypothesis
Authors: Gibson P. R. , Shepherd S. J. 
Published: June 2005

SummarySusceptibility to the development of Crohn's disease involves a combination of genetic and environmental factors. The association of Crohn's disease with westernization has implicated lifestyle factors in pathogenesis. While diet is a likely candidate, evidence for specific changes in dietary habits and/or intake has been lacking.A new hypothesis is proposed, by which excessive delivery of highly fermentable but poorly absorbed short‐chain carbohydrates and polyols (designated FODMAPs – Fermentable Oligo‐, Di‐ and Mono‐saccharides And Polyols) to the distal small intestinal and colonic lumen is a dietary factor underlying susceptibility to Crohn's disease. The subsequent rapid fermentation of FODMAPs in the distal small and proximal large intestine induces conditions in the bowel that lead to increased intestinal permeability, a predisposing factor to the development of Crohn's disease. Evidence supporting this hypothesis includes the increasing intake of FODMAPs in western societies, the association of increased intake of sugars in the development of Crohn's disease, and the previously documented effects of the ingestion of excessive FODMAPs on the bowel. This hypothesis provides potential for the design of preventive strategies and raises concern about current enthusiasm for putative health‐promoting effects of FODMAPs.One of the greatest challenges in defining the pathogenesis of Crohn's disease is to identify predisposing environmental factors. Such an achievement might lead to the development of preventive strategies for, and the definition of, possible target for changing the natural history of this serious disease. The present paper describes a new hypothesis for one such environmental factor.
Postprandial oesophageal integrated acidity is a reliable predictor of gastro‐oesophageal reflux disease
Authors: Shih G. L. , Brensinger C. M. , Katzka D. A. , Metz D. C. 
Published: June 2005

SummaryBackground : Measurement of oesophageal acid exposure parameters postprandially has been shown to distinguish gastro‐oesophageal reflux disease patients from normal individuals.Aims : To calculate the accuracy of postprandial oesophageal integrated acidity in diagnosing gastro‐oesophageal reflux disease.Methods : Ambulatory 24‐h pH studies of 626 patients were analysed retrospectively. Gastro‐oesophageal reflux disease, defined as pH < 4 for >4.2% of time, was identified in 305 subjects. Postprandial oesophageal integrated acidity was measured for 2 and 3 h after the largest meal peak as determined from gastric pH. Postprandial symptom‐associated probability was calculated.Results : Gastro‐oesophageal reflux disease subjects had a greater postprandial oesophageal integrated acidity than non‐gastro‐oesophageal reflux disease subjects [median (IQR): 0.57 (0.08–2.66) vs. 0.03 (0.01–0.15) mmol*h/L]. Median postprandial oesophageal integrated acidity did not differ with gender or age in gastro‐oesophageal reflux disease and non‐gastro‐oesophageal reflux disease subjects (P > 0.05 for all). A 3‐h postprandial oesophageal integrated acidity value of 0.121 mmol*h/L had a 71.1% sensitivity and 71.7% specificity in diagnosing gastro‐oesophageal reflux disease. Gastro‐oesophageal reflux disease subjects with symptoms had a higher postprandial oesophageal integrated acidity than those without (P = 0.043), whereas non‐gastro‐oesophageal reflux disease subjects with and without symptoms did not differ (P = 0.74). The correlation between symptom‐associated probability and postprandial oesophageal integrated acidity was poor (gastro‐oesophageal reflux disease: r = 0.15; non‐gastro‐oesophageal reflux disease: r = 0.25).Conclusion : Postprandial oesophageal integrated acidity provides a robust estimation of oesophageal acid exposure and may predict symptoms in gastro‐oesophageal reflux disease patients.
Gender difference on the symptoms, health‐seeking behaviour, social impact and sleep quality in irritable bowel syndrome: a Rome II‐based survey in an apparent healthy adult Chinese population in Taiwan
Authors: Lu C.‐L. , Chang F.‐Y. , Lang H.‐C. , Chen C.‐Y. , Luo J.‐C. , Lee S.‐D. 
Published: June 2005

SummaryBackground : Little is known about the gender effect on irritable bowel syndrome in Asia.Aim : To assess the gender difference in Chinese subjects with irritable bowel syndrome meeting Rome II criteria.Methods : Irritable bowel syndrome was identified from an apparently healthy adult population receiving a routine health maintenance program (n = 2018).Results : Female gender is not a factor associated with irritable bowel syndrome or irritable bowel syndrome‐related health care‐seeking behaviour. Female irritable bowel syndrome subjects, irrespective of consulting behaviour for irritable bowel syndrome, are likely to have <3 bowel movements/week, hard/lumpy stools and abdominal fullness/bloating (P < 0.05). Female irritable bowel syndrome subjects are prone to be absent from school/work with more days of absenteeism, irrespective of consultation status (P < 0.05). Only female irritable bowel syndrome consulters have more absenteeism for their irritable bowel syndrome‐related symptoms, reporting more sleep disturbances than their male counterparts (P < 0.001).Conclusions : In an apparent healthy adult population in Taiwan, gender difference is present in Rome II defined Chinese subjects with irritable bowel syndrome as regards bowel symptoms, social impact and sleep quality. Female predominance was not found in irritable bowel syndrome subjects and irritable bowel syndrome‐related health care‐seeking behaviour in the current population. Both irritable bowel syndrome non‐consulters and consulters have similar gender difference profiles in presenting symptoms, suggesting that bowel symptoms per se may not be the only factor leading to health care‐seeking behaviour. The gender differences in sleep problems were observed solely in irritable bowel syndrome consulter.
Comparison of the effects of immediate‐release omeprazole powder for oral suspension and pantoprazole delayed‐release tablets on nocturnal acid breakthrough in patients with symptomatic gastro‐oesophageal reflux disease
Authors: Castell D. , Bagin R. , Goldlust B. , Major J. , Hepburn B. 
Published: June 2005

SummaryBackground : Many patients treated with a proton‐pump inhibitor for gastro‐oesophageal reflux disease or erosive oesophagitis still have substantial night‐time gastric acidity. A previous trial of a new immediate‐release omeprazole oral suspension suggested that nocturnal gastric acidity could be more effectively controlled with a bedtime dose of immediate‐release omeprazole than with a delayed‐release proton‐pump inhibitor administered before dinner or at bedtime.Aim : To compare the ability of immediate‐release omeprazole with pantoprazole to control nocturnal gastric acidity, when they were dosed once daily and twice daily.Methods : Thirty‐six patients with nocturnal gastro‐oesophageal reflux disease symptoms received immediate‐release omeprazole and pantoprazole in this open‐label, randomized‐crossover trial. Median gastric pH, the percentage of time with gastric pH > 4 and the percentage of patients with nocturnal acid breakthrough, were evaluated with 24‐h pH monitoring.Results : Repeated once daily (bedtime) dosing with immediate‐release omeprazole suspension produced significantly better nocturnal gastric acid control than repeated once daily (predinner) or twice daily (prebreakfast and bedtime) dosing with pantoprazole delayed‐release tablets (median pH: 4.7 vs. 2.0 and 1.7; percentage of time pH > 4: 55 vs. 27 and 34; nocturnal acid breakthrough: 53 vs. 78 and 75). Twice daily dosing (prebreakfast and bedtime) with immediate‐release omeprazole 20 and 40 mg achieved the best night‐time control of gastric acidity. Repeated once daily bedtime dosing with immediate‐release omeprazole 40 mg and twice daily dosing with pantoprazole 40 mg gave similar 24‐h pH control. No safety issues were associated with either drug in this trial.Conclusions : Dosed once daily at bedtime, immediate‐release omeprazole reduced nocturnal gastric acidity to a degree not observed with once daily dosing of delayed‐release proton‐pump inhibitors.
Variation in the use of H. pylori tests in UK general practice – a qualitative study
Authors: McNulty C. A. M. , Freeman E. , Bowen J. , Delaney B. C. 
Published: June 2005

SummaryBackground : Although serology is the main Helicobacter pylori test used by general practitioners in the UK, there is no information available on variation in requesting rates.Aim : To explore the reasons for any variation in H. pylori serology testing by general practices in the UK using qualitative methods.Methods : Serology requesting rates were determined using laboratory and population data. Staff from randomly selected practices in the lowest and highest quintiles of testing attended focus groups to discuss the management of H. pylori and dyspepsia. Transcribed data were analysed using an interpretative phenomenological approach.Results : Serology submission varied 600‐fold (0.1–59/1000 population/year) and H. pylori positivity rate 17–100%. Low‐testing practices were less aware of the benefits of H. pylori testing and had shorter endoscopy waiting times. They preferred endoscopy diagnosis over serology test. Three high‐testing practices had a high non‐white population with high H. pylori positivity. Most staff knew little about the predictive value of serology, the availability of urea breath test on prescription or the existence of a stool test.Conclusions : Seroprevalence of H. pylori is still high in dyspeptics, especially in non‐white populations. Laboratories and primary care trusts should audit H. pylori requests and endoscopy referrals, target education at high endoscopy referrers and low H. pylori testers and inform clinicians of the more accurate H. pylori tests and NICE dyspepsia guidance.
Gender and liver fibrosis in chronic hepatitis: the role of iron status
Authors: Rigamonti C. , Andorno S. , Maduli E. , Capelli F. , Boldorini R. , Sartori M. 
Published: June 2005

SummaryBackground : The role of gender in the progression of fibrosis in chronic hepatitis C is still under investigation.Aim : To investigate whether gender affects the progression of liver disease and/or hides other risk factors.Methods : A prospective series of 121 consecutive patients with chronic hepatitis C underwent liver biopsy. Grading and staging for chronic hepatitis were each evaluated according to Ishak's classification.Results : In univariate and multivariate analysis on the whole group of patients, male gender was not associated either with significant liver fibrosis (Ishak's score >2) or with cirrhosis (Ishak's score >4). On the contrary, in univariate analysis on patients aged ≤50 years, male gender was nearly significantly (P = 0.06) predictive of liver fibrosis, whereas it was not in patients >50 years. Hepatic iron grading, along with age, was an independent factor associated with fibrosis. Moreover, the values of all the variables which describe iron status were significantly higher in males aged ≤50 years in comparison with females of the same age.Conclusions : In chronic hepatitis C, male gender may be predictive of liver fibrosis only in patients aged≤50 years. Among fibrogenetic factors hidden by gender, iron status could play a major role.
High rate of Helicobacter pylori eradication with sequential therapy in elderly patients with peptic ulcer: a prospective controlled study
Authors: Zullo A. , Gatta L. , De Francesco V. , Hassan C. , Ricci C. , Bernabucci V. , Cavina M. , Ierardi E. , Morini S. , Vaira D. 
Published: June 2005

SummaryBackground : Helicobacter pylori eradication rates with triple therapies are decreasing, and few data in elderly patients are available. A 10‐day sequential regimen succeeded in curing such H. pylori infection in unselected patients.Aim : To compare this sequential regimen and the standard triple therapy for H. pylori eradication in geriatric patients with peptic ulcer.Methods : Overall, 179 H. pylori‐infected patients with peptic ulcer were enrolled (mean age: 69.5 years; range: 65–83). Patients were randomized to 10‐day sequential therapy (rabeprazole 20 mg b.d. plus amoxicillin 1 g b.d. for the first 5 days, followed by rabeprazole 20 mg, clarithromycin 500 mg and tinidazole 500 mg, all b.d., for the remaining 5 days) or standard 7‐day triple regimen (rabeprazole 20 mg, clarithromycin 500 mg and amoxicillin 1 g, all b.d.). Helicobacter pylori status was assessed by histology and rapid urease test at baseline and 4–6 weeks after completion of treatment.Results : The sequential regimen achieved eradication rates significantly higher in comparison with the standard regimen at both intention‐to‐treat (94% vs. 80%; P = 0.008) and per‐protocol (97% vs. 83%; P = 0.006) analyses. In both treatment groups, compliance to the therapy was high (>95%), and the rate of mild side‐effects was similarly low (<12%). At repeated upper endoscopy, peptic ulcer lesions were healed in 97% patients, without a statistically significant difference between the sequential regimen and the standard triple therapy.Conclusions : In elderly patients with peptic ulcer disease, the 10‐day sequential treatment regimen achieved significantly higher eradication rates in comparison with standard triple therapy.