bluuebunny/crossref_metadata_2025_split huggingface dataset:
Helicobacter pylori and molecular events in precancerous gastric lesions
Authors: Nardone G. , Rocco A. , Malfertheiner P. 
Published: July 2004

SummaryGastric cancer can be divided into intestinal type and diffuse type that differ substantially in epidemiology and pathogenesis. The most important aetiological factor associated both with intestinal and diffuse gastric cancer, is Helicobacter pylori.Exposure of gastric epithelial cells to H. pylori results in an inflammatory reaction with the production of reactive oxygen species and nitric oxide that, in turn, deaminates DNA causing mutations. The complex interplay between H. pylori strain, inflammation and host characteristics may directly promote diffuse type gastric cancer or induce a cascade of morphological events, i.e. atrophy, intestinal metaplasia and dysplasia, finally leading to intestinal type gastric cancer. Two mechanisms, genetic and epigenetic have been held to play a role in the molecular alterations underlying gastric carcinogenesis. The former, comprising changes in the DNA sequence, is irreversible; the latter, involving DNA methylation, is potentially reversible by eliminating the triggering agents. If H. pylori is eradicated before development of stable mutations, the risk of gastric cancer will likely be prevented. Thus, eradication of H. pylori might immediately reduce the risk of diffuse type gastric cancer, whereas prevention of intestinal type gastric cancer may be less effective if patients are treated later in the evolution of the carcinogenic process.
Health‐related quality of life of patients with gastrointestinal symptoms
Authors: Bovenschen H. J. , Laheij R. J. F. , Tan A. C. I. T. L. , Witteman E. M. , van Rossum L. G. M. , Jansen J. B. M. J. 
Published: July 2004

SummaryBackground : Little is known about the variation in health‐related quality of life among patients with different presentations of gastrointestinal symptoms.Aim : To study the association between health‐related quality of life and presentations of gastrointestinal symptoms.Methods : Health‐related quality of life and demographic information was obtained from 873 patients referred to the hospital for endoscopy, using a questionnaire.Results : A total of 436 patients (50%) reported predominantly upper gastrointestinal symptoms, 344 (39%) predominantly lower symptoms, and 93 (11%) patients reported both upper and lower symptoms. Patients with mild, moderate and severe symptoms, reported mean scores on a 100‐point visual analogue scale (95% CI) of 90 (79–100), 75 (64–86) and 64 (53–76), respectively (P < 0.001). Mean visual analogue scale scores (95% CI) almost linearly declined from 81 (77–85) to 49 (46–52) for those with one to those with more than eight symptoms. Patients who reported upper gastrointestinal symptoms and in particular epigastric pain, bloating and vomiting had significantly impaired health status in comparison to patients without these symptoms (P < 0.05).Conclusions : Severity of gastrointestinal symptoms is the most important factor in affecting health status, followed by the numbers and type of gastrointestinal symptoms.
Helicobacter pylori eradication in children and adolescents by a once daily 6‐day treatment with or without a proton pump inhibitor in a double‐blind randomized trial
Authors: Tindberg Y. , Casswall T. H. , Blennow M. , Bengtsson C. , Granström M. , Sörberg M. 
Published: July 2004

SummaryAim : To evaluate two simplified Helicobacter pylori eradication treatment alternatives for children and adolescents.Methods : Study subjects were identified by enzyme‐linked immunosorbent assay and immunoblot in a family screening project. Helicobacter pylori infected 10–21 year olds were offered treatment, individuals with abdominal pain underwent upper endoscopy and those with peptic ulcers were excluded. Participants were randomized to either azithromycin 500 mg daily and tinidazole 500 mg two tablets daily in combination with lansoprasole 30 mg daily for 6 days (ATL‐group) or with placebo (ATP‐group). Urea Breath Test was performed at inclusion and after a minimum of 6 weeks after end of therapy.Results : In total, 131 individuals were randomized, of whom 31 (24%) had undergone upper endoscopy. Full compliance was achieved in 93% (122 of 131). The intention‐to‐treat eradication rate was 67% (44 of 66) and 58% (38 of 65) for the ATL‐ and the ATP‐group, respectively.Conclusion : The double‐blind randomized clinical trial did not identify a simplified, successful once daily H. pylori treatment for children and adolescents. Thus, twice daily proton pump inhibitor (PPI)‐based triple therapies for 7 days remain as the choice of treatment in children. Further, powerful and controlled studies are needed to elucidate the best treatment strategies for H. pylori eradication in this age group.
Economic analysis of strategies in the prevention of non‐steroidal anti‐inflammatory drug‐induced complications in the gastrointestinal tract
Authors: Lanas A. 
Published: July 2004

SummaryBackground : It is unclear what the best therapeutic approach is in patients who require non‐steroidal anti‐inflammatory drugs. In clinical practice, choice of prescriptions are often based on drug costs.Aim : To evaluate costs per upper gastrointestinal bleeding avoided with different prevention strategies.Methods : Two major strategies have been considered (coxibs vs. non‐steroidal anti‐inflammatory drugs plus generic/brand gastroprotective agent). The number of patients needed to treat to prevent a bleeding event, the cost of the drug and duration of treatment were used to estimate costs.Results : Based on hospitalization costs of a bleeding event, no therapeutic strategy is cost‐effective in patients without risk factors. All strategies (including omeprazole + coxib) are cost‐effective in patients with bleeding ulcer history. With other risk factors, all strategies are cost‐effective but prevention of events is twice as expensive in patients <75 years of age. No strategy shows superiority unless the cheapest generics are prescribed or a 50% reduction in the incidence of lower gastrointestinal complications with coxibs is confirmed.Conclusions : Current prevention strategies to reduce serious non‐steroidal anti‐inflammatory drug‐associated gastrointestinal events are only cost‐effective in patients with risk factors. No strategy shows superiority, but coxib strategy would be more cost‐effective if it were associated with a reduction of events of the lower gastrointestinal tract.
Hepatic hydrothorax
Authors: Cardenas A. , Kelleher T. , Chopra S. 
Published: July 2004

SummaryPatients with cirrhosis and portal hypertension often have abnormal extracellular fluid volume regulation, resulting in accumulation of fluid as ascites, oedema or pleural effusion. These complications carry a poor prognosis with nearly half of the patients with ascites dying in the ensuing 2–3 years. In contrast to what happens in the abdominal cavity where large amounts of fluid (5–8 L) accumulate with the patient only experiencing only mild symptoms, in the thoracic cavity smaller amounts of fluid (1–2 L) cause severe symptoms such as shortness of breath, cough and hypoxaemia. Hepatic hydrothorax is defined as a pleural effusion, usually >500 mL, in patients with cirrhosis without cardiopulmonary disease. The pathophysiology involves the direct movement of ascitic fluid from the peritoneal cavity into the pleural space through diaphragmatic defects. The estimated prevalence among cirrhotic patients is 5–10%. The effusion, which is a transudate, most commonly occurs in the right hemithorax. The mainstay of therapy is similar to that of portal hypertensive ascites and includes sodium restriction and administration of diuretics. Refractory hydrothorax can be managed with transjugular intrahepatic portosystemic shunt in selected cases. Pleurodesis is not routinely recommended. Suitable patients with hepatic hydrothorax should be considered candidates for liver transplantation.
A novel option in proton pump inhibitor dosing: lansoprazole orally disintegrating tablet dispersed in water and administered via nasogastric tube
Authors: Freston J. W. , Kukulka M. J. , Lloyd E. , Lee C. 
Published: August 2004

SummaryBackground : Lansoprazole orally disintegrating tablet, which rapidly disintegrates on the tongue or in water, provides a dosing alternative for patients with difficulty in swallowing. Gastric and nasogastric tubes are increasingly placed in patients with more severe swallowing disorders.Aim : This study assessed the pharmacokinetic profile of lansoprazole orally disintegrating tablet dispersed in a small volume of water and administered through a small‐bore nasogastric tube.Methods : Forty healthy adult men and women (18–43 years) received two single 30 mg lansoprazole orally disintegrating tablet doses (one administered directly onto the tongue without water, and one dispersed in water and administered via nasogastric tube) in a randomized, crossover fashion.Results : The total plasma exposure to lansoprazole was comparable following both dosing regimens; mean AUC values for the lansoprazole orally disintegrating tablet nasogastric dispersion were ≤8.6% greater than those for the intact lansoprazole orally disintegrating tablet. Lansoprazole Cmax for the lansoprazole orally disintegrating tablet nasogastric dispersion was 20.9% greater than that for the intact lansoprazole orally disintegrating tablet, a difference of no clinical significance.Conclusions : Dispersion of the lansoprazole orally disintegrating tablet in a small volume of water and administering via nasogastric tube does not reduce the pharmacokinetic profile of the intact lansoprazole orally disintegrating tablet. This alternative dosing method may be useful in patients with nasogastric or gastric tubes.
The impact of immigration on the increasing incidence of hepatocellular carcinoma in the United States
Authors: Kulkarni K. , Barcak E. , El‐Serag H. , Goodgame R. 
Published: August 2004

SummaryAims : To assess if the rising incidence of hepatocellular carcinoma in the United States can be accounted for by immigration and an ageing population, or is a true increase among the USA‐born residents.Methods : Design– A retrospective chart review. Setting– Urban, multiethnic hospital and specialty clinics in a large indigent health system in Houston, Texas. Subjects– Approximately 23 000 admissions and 143 000 out‐patient clinic visits each year from 1992 through 2001 were assessed. A total of 494 patient records were selected and reviewed because of suspicion of hepatocellular carcinoma. Analysis– Hepatocellular carcinoma was confirmed by histopathology, α‐fetoprotein level >400 ng/mL, and suggestive imaging studies. The age‐adjusted incidence was determined and causative factors were identified.Results : About 111 cases of confirmed hepatocellular carcinoma were found. The age‐adjusted incidence rose from 3.44 per 100 000 hospital admissions during 1992–1996 (95% confidence interval: 2.86–4.02) to 5.19 during 1997–2001 (95% confidence interval: 4.41–5.97). The proportion of patients of non‐USA place of birth decreased between 1992–1996 and 1997–2001 (46–24%, respectively, P = 0.03). Fifty‐two per cent and 68% were hepatitis C virus‐positive respectively; 37% and 34% were hepatitis B surface antigen‐positive respectively; 46% and 59% had a history of alcohol abuse; and 22% and 11% had no identifiable risk factors.Conclusions : The incidence of hepatocellular carcinoma within the greater Houston area has increased during the past decade, rising by 51% from 1992–1996 to 1997–2001. This increase is not from immigration or population ageing but represents a true rise among the native born population. Hepatitis C and alcoholic cirrhosis are associated with a majority of cases, particularly in the latter half of the decade.
Rationale and proposed algorithms for symptom‐based proton pump inhibitor therapy for gastro‐oesophageal reflux disease
Authors: Bytzer P. , Blum A. L. 
Published: August 2004

SummaryGastro‐oesophageal reflux disease and non‐erosive reflux disease are chronic, highly prevalent conditions requiring long‐term treatment that is both effective and practical. On‐demand therapy with a proton pump inhibitor may meet that need. It is becoming a mainstay of long‐term treatment because it reduces the risk of over‐ and under‐treatment, is cost‐effective and user friendly. Epidemiological and clinical observations speak also in its favour. However, for the anticipated benefits of on‐demand therapy to accrue in clinical practice, on‐demand treatment algorithms are required. These algorithms must specify the initial evaluation and treatment of candidates, and follow‐up protocols for an on‐demand strategy. Our group has developed such algorithms, which are presented here.
A review of the potential uses for recombinant human TSH in patients with thyroid cancer and nodular goiter
Authors: Woodmansee Whitney W. , Haugen Bryan R. 
Published: July 2004

SummaryRecombinant human TSH (rhTSH) has revolutionized the care of patients with differentiated thyroid cancer. Since its approval for clinical use in 2001 in Europe (1998 in the USA), rhTSH has greatly enhanced the surveillance of these patients by allowing the avoidance of hypothyroidism for TSH stimulation. Previously, a hypothyroid state was required for TSH stimulated diagnostic whole‐body radio‐iodine scans (DxWBS) and thyroglobulin (Tg) levels. Patients generally prefer rhTSH as a mechanism for TSH stimulation because symptoms of hypothyroidism can be completely avoided. Currently, rhTSH is only approved for diagnostic monitoring of differentiated thyroid cancer patients. There are many other potential uses for rhTSH, including facilitation of treatment of patients with thyroid cancer and nodular goiter. The diagnostic and therapeutic role of rhTSH in patients with differentiated thyroid cancer and nodular goiter will be discussed in this review.
Aldosterone synthase gene variation and adrenocortical response to sodium status, angiotensin II and ACTH in normal male subjects
Authors: Kennon Brian , Ingram Mary C. , Friel Elaine C. , Anderson Niall H. , MacKenzie Scott M. , Davies Eleanor , Shakerdi Loai , Wallace A. Michael , Fraser Robert , Connell John M. C. 
Published: July 2004

Summaryobjective  Aldosterone synthase, a key enzyme in the terminal steps of aldosterone synthesis, is encoded by the CYP11B2 gene. A polymorphism in the 5′ coding region of this gene (−344 C/T) is associated with hypertension, particularly with elevation of the aldosterone to renin ratio. A second polymorphism (a conversion in intron 2 to resemble that of the neighbouring 11β‐hydroxylase (CYP11B1) gene) is found in close linkage dysequilibrium with the variant at −344 C/T. The mechanism by which these variants predispose to cardiovascular disease and the precise intermediate phenotype associated with them remains speculative.design  We performed a focused physiological study in normal volunteers stratified by CYP11B2 genotype.patients  Twenty‐three subjects homozygous for the T allele and 21 homozygous for the C allele of the −344 C/T polymorphism of CYP11B2 were studied.measurements  Basal and angiotensin II stimulated plasma and 24‐h urinary steroid excretion during low (60 mmol/day) and high (160 mmol/day) sodium intake and plasma steroids after ACTH stimulation were measured.results  No influence of polymorphic variation on basal or stimulated plasma cortisol or aldosterone or other plasma steroid concentrations during either dietary phase was seen. However, excretion of tetrahydro‐11‐deoxycortisol (the urinary metabolite of 11‐deoxycortisol), which is the precursor of cortisol) was increased in TT subjects during sodium restriction, consistent with impairment of zona fasciculata 11β‐hydroxylation.conclusions  We conclude that this polymorphism has no major influence on normal zona glomerulosa function but is associated with a change in 11β‐hydroxylation in the zona fasciculata. The mechanism remains uncertain, but alteration of 11‐deoxycortisol levels without change in cortisol suggests altered efficiency of 11β‐hydroxylation. In the long term, this may lead to a minor but chronic increase in ACTH drive to the gland, which may have consequences for steroid synthesis and predispose to the risk of cardiovascular disease.
Proton magnetic resonance spectroscopy and single photon emission computed tomography study of the brain in asymptomatic young hyperlipidaemic Asian Indians in North India show early abnormalities
Authors: Sinha Sanjeev , Misra Anoop , Kumar Virendra , Jagannathan N. R. , Bal C. S. , Pandey Ravindra Mohan , Singhania Rohit , Deepak  
Published: July 2004

Summaryobjective  To evaluate brain metabolism and cerebral blood flow in young patients with hyperlipidaemia.patients and methods  Proton magnetic resonance spectroscopy (1H MRS) and single photon emission computed tomography (SPECT) of the brain was carried out in 19 asymptomatic young patients with hyperlipidaemia (mean age 32·6 ± 6·0 years, range 22–45 years) and 21 age‐matched healthy controls divided into the following three groups; (i) hyperlipidaemics on pharmacological treatment (group 1, n = 13), (ii) hyperlipidaemics not on pharmacological treatment (group 2, n = 6) and (iii) control group of healthy subjects (group 3, n = 21).results  No statistical difference was observed in the brain metabolite ratios between controls and hyperlipidaemic patients (both treatment naive and treated) in the 1H NMR study. Two hyperlipidaemic patients showed a lactate peak and one had a lipid peak. The SPECT study was abnormal in seven hyperlipidaemic patients. In the pooled data, 50% subjects with high serum triglyceride (TG) levels as opposed to 14% subjects with normal serum TG levels showed cerebral hypoperfusion. The choline/creatine (Cho/Cr) ratio of the occipital region of the brain showed correlation with the excess percentage of body fat (%BF) and low levels of high density lipoprotein cholesterol (HDL‐C) compared to those with normal %BF and normal HDL‐C levels, respectively, in pooled data of all subjects. The N‐acetyl aspartate (NAA)/Cho ratio also showed correlation with hypercholesterolaemia. Serum TG levels were positively correlated with the NAA/Cr ratio (r = 0·62, P < 0·05) and the Cho/Cr ratio (r = 0·63, P < 0·05) in the parieto‐temporal area in group 1 patients.conclusion  The study revealed no difference in the brain metabolite ratios between controls and hyperlipidaemic patients, while some hyperlipidaemic patients showed abnormalities of cerebral blood flow. Brain metabolite ratios were also influenced by certain parameters of body composition and lipids. As abnormal body composition, hypertriglyceridaemia and low levels of HDL‐C are prevalent in Asian Indians, such data are important and indicate a need for further study.
Genetics of endometriosis: a role for the progesterone receptor gene polymorphism PROGINS?
Authors: Lattuada Debora , Somigliana Edgardo , Viganò Paola , Candiani Massimo , Pardi Giorgio , Di Blasio Anna Maria 
Published: July 2004

Summaryobjective  Endometriosis is a steroid‐dependent disease with a particular genetic background, but the locations of possible genomic aberrations are still poorly clarified. We have investigated the potential association between endometriosis and the PROGINS 306 base pair insertion polymorphism in intron G of the progesterone receptor (PR) gene, which has been reported previously to segregate with this disease.design  In a case‐control study, we examined the PROGINS polymorphism of the progesterone receptor gene in 131 Italian women affected by endometriosis diagnosed according to published criteria for the definition of the definite disease. Control subjects were represented by 127 Italian women without laparoscopic evidence of the disease.measurements  Peripheral blood samples, DNA extraction and polymerase chain reaction (PCR) were used to genotype women for the presence of the PROGINS polymorphism.results  We found a statistically significant difference in the distribution of PROGINS genotypes between patients with and without endometriosis. The frequency of the PROGINS allele T2 was 17·2% and 11%, respectively, in affected women and in controls [odds ratio (OR) = 1·7, 95% confidence interval (CI) 1·0–2·8]. This association was stronger in patients with more severe forms of endometriosis, such as an infiltrating disease or a disease characterized by severe pelvic adhesions (OR 2·4, 95% CI 1·2–4·8; and OR 2·7, 95% CI 1·4–5·3, respectively). Combination of the results from an earlier study and the current data indicates that carrying the allele variant T2 is associated with a twofold increase in the risk of developing endometriosis (OR 2·0, 95% CI 1·3–2·9).conclusions  Our results further support the idea that the PROGINS polymorphism of the progesterone receptor may be associated with an increased risk of endometriosis.
A polymorphic CA repeat in the IGF‐I gene is associated with gender‐specific differences in body height, but has no effect on the secular trend in body height
Authors: Rietveld I. , Janssen J. A. M. J. L. , Van Rossum E. F. C. , Houwing‐Duistermaat J. J. , Rivadeneira F. , Hofman A. , Pols H. A. P. , Van Duijn C. M. , Lamberts S. W. J. 
Published: July 2004

Summaryobjective  A polymorphism near the promoter region of the IGF‐I gene has been associated with serum IGF‐I levels, age‐related decline of serum IGF‐I levels, body height, birth weight and intima media thickness in hypertensive subjects.design and methods  We investigated the association between the length of the IGF‐I alleles of this promoter polymorphism and IGF‐I levels and body height. Furthermore, we investigated the potential influence of this polymorphism on final height in relationship to the secular trend of individuals born between 1917 and 1945. All subjects were participants of the Rotterdam Study.results  We observed, in analyses including only homozygous carriers, the highest IGF‐I levels in homozygous carriers of the 192‐bp allele (18·7 nmol/l ± 0·6) and homozygous carriers of the 194‐bp allele (17·7 nmol/l ± 1·4). IGF‐I levels were significantly lower in individuals with homozygous longer alleles [> 194‐bp (12·0 nmol/l ± 1·2; P < 0·001)] and homozygous shorter alleles [< 192‐bp (15·6 nmol/l ± 1·4; P < 0·05)] compared to homozygous carriers of the 192‐bp and the 194‐bp allele. In males and females separately, an optimum for serum IGF‐I was also observed in homozygous carriers of the 192‐bp and 194‐bp allele. Only in males, homozygous carriers of the 192‐bp allele were significantly taller than homozygous carriers of the shorter alleles (174·9 cm ± 0·2 vs. 171·5 cm ± 1·4; P = 0·01). When all subjects genotyped for the IGF‐I promoter polymorphism were included in the analysis, a clear optimum for IGF‐I levels and body height was observed in carriers of the 192‐bp and/or 194‐bp allele in the total population. Between 1917 and 1945, a secular trend in body height was observed in our Dutch population. Mean final body height was significantly higher in carriers of the most frequent alleles (192‐bp and/or the 194‐bp), than carriers of the remaining shorter and longer genotypes (P‐trend < 0·01).conclusions  In conclusion, we observed an optimum in IGF‐I levels and final body height for the 192‐bp and 194‐bp allele of the IGF‐I gene. A gender‐specific effect of the IGF‐I alleles on body height was observed. The secular trend in body height observed in our elderly Dutch population was similar for the different genotypes; carriers of the 192‐bp and/or the 194‐bp allele remained significantly taller throughout time.