bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of 1‐week vs. 2‐ or 4‐week therapy regimens with ranitidine bismuth citrate plus two antibiotics for Helicobacter pylori eradication
Authors: Kamberoglou D. , Polymeros D. , Sanidas I. , Doulgeroglou V. , Savva S. , Patra E. , Tzias V. 
Published: March 2003

Background: Helicobacter pylori eradication therapies based on ranitidine bismuth citrate have recently been introduced in clinical practice.Aim:To compare the efficacy of three regimens containing ranitidine bismuth citrate given for 1, 2 and 4 weeks, combined with two antibiotics for the first week, in the eradication of H. pylori.Methods:Eighty‐six consecutive patients (50 duodenal ulcer disease, 36 non‐ulcer dyspepsia) with H. pylori infection were offered three eradication regimens: (a) 1‐week group (n=28), ranitidine bismuth citrate 400 mg b.d. for 7 days; (b) 2‐week group (n=29), ranitidine bismuth citrate 400 mg b.d. for 14 days; and (c) 4‐week group (n=29), ranitidine bismuth citrate 400 mg b.d. for 28 days. In all patients, clarithromycin 500 mg b.d. and metronidazole 500 mg b.d. were given for the first week. Endoscopy was repeated 1 month after the end of treatment and eradication was considered to be successful if both rapid urease test and histology were negative.Results:Overall, H. pylori was eradicated in 84% (72/86) patients on intention‐to‐treat analysis, whereas the per protocol cure rate was 89% (72/81). Eradication rates were 23/27 (85%) (95% confidence interval (CI): 66–96%), 25/27 (92%) (95% CI: 76–99%) and 24/27 (89%) (95% CI: 71–98%) in the 1‐, 2‐ and 4‐week groups, respectively, on per protocol analysis, and 25/28 (82%) (95% CI: 63–94%), 25/29 (86%) (95% CI: 68–96%) and 24/29 (83%) (95% CI: 64–94%), respectively, on intention‐to‐treat analysis (P > 0.05, N.S.). No significant differences were observed between groups concerning duodenal ulcer healing, resolution of symptoms and adverse effects.Conclusions:The 1‐week regimen with ranitidine bismuth citrate, clarithromycin and metronidazole is effective in H. pylori eradication. Prolongation of treatment with ranitidine bismuth citrate for 2 or 4 weeks does not achieve a statistically significant more favourable outcome.
Gastrimmune‐induced antigastrin‐17 antibodies inhibit acid secretion in a rat fistula model
Authors: Smith A. M. , Morris T. , Justin T. , Michaeli D. , Watson S. A. 
Published: March 2003

Background:Gastrimmune is an immunogenic form of gastrin. It raises in situ antibodies against two proliferative forms of gastrin: amidated and glycine‐extended gastrin‐17. It has been shown to have a therapeutic action in several in vivo tumour models. Following immunization, due to the complex equilibrium that exists between the antibodies and gastrin, it is not technically feasible to assay for free gastrin.Aim:To determine the effect of Gastrimmune‐induced antigastrin antibodies on acid secretion.Method:A rat gastric fistula model was used. Animals (six per group) were immunized with a control immunogen or ascending doses of Gastrimmune. Acid output was measured following infusion of increasing doses of gastrin‐17 and pentagastrin.Results:Gastrimmune‐induced antibodies significantly reduced gastrin‐17‐stimulated acid output compared to control animals (Gastrimmune at 200 μg/rat vs. control; acid output following 30 ng gastrin‐17, 0.01 vs. 0.16, P < 0.001; following 120 ng gastrin‐17, 0.022 vs. 0.29, P < 0.001).Conclusions:Gastrimmune significantly inhibits gastrin‐17‐stimulated acid output. This biological assay suggests that the antigastrin antibodies effectively bind gastrin‐17. In addition to its use as an antineoplastic agent, Gastrimmune may have a role as an acid‐decreasing agent in oesophagogastric pathology.
Impairment of cytochrome P‐450‐dependent liver activity in cirrhotic patients with Helicobacter pylori infection
Authors: Giannini E. , Fasoli A. , Borro P. , Chiarbonello B. , Malfatti F. , Romagnoli P. , Botta F. , Testa E. , Fumagalli A. , Polegato S. , Savarino V. , Testa R. 
Published: March 2003

Background: Helicobacter pylori gastric infection has been associated with various digestive and extra‐digestive diseases. The systemic influence of gastric H. pylori infection seems to be mediated by the release of various cytokines. In liver disease, bacterial infections have been associated with the impairment of liver metabolic function.Aims:To evaluate the influence of H. pylori infection on liver function as assessed by means of the monoethylglycinexylidide test, which depends upon liver blood flow and cytochrome P‐450 activity, and the 13C‐galactose breath test, which depends on cytosolic enzymatic activity and is correlated with hepatic functional mass. Moreover, to evaluate whether H. pylori‐associated modifications of liver function may be related to tumour necrosis factor‐α serum levels.Patients and methods:Thirty‐five patients with liver cirrhosis of various aetiologies, who underwent monoethylglycinexylidide and 13C‐galactose breath tests, were retrospectively evaluated for H. pylori infection by means of anti‐H. pylori immunoglobulin G. The main clinical, biochemical and functional characteristics of the patients as well as their tumour necrosis factor‐α serum levels were then analysed on the basis of the presence of H. pylori infection.Results:Twenty‐one patients tested positive for H. pylori infection (60%), and 11 tested negative (31.4%). No clinical or biochemical differences were observed between H. pylori‐infected and non‐infected patients. H. pylori infection showed no difference in distribution according to Child–Pugh classes (A, 55%; B and C, 67%). The monoethylglycinexylidide test results were significantly lower at each sampling time in H. pylori‐positive patients compared to H. pylori‐negative patients (MEGX15, P=0.027; MEGX30, P=0.014; MEGX60, P=0.028), while 13C‐galactose breath test showed no significant differences considering both cumulative percentage dose and percentage dose/h. The median tumour necrosis factor‐α serum levels were no different between H. pylori‐positive (16.1 pg/mL, 95% confidence interval, 8.7–28.7) and H. pylori‐negative (12.3 pg/mL, 95% confidence interval, 8.7–23.4) patients.Conclusions:In cirrhotic patients, H. pylori infection seems to selectively affect cytochrome P‐450 liver activity, while hepatic functional mass does not seem to be impaired. Tumour necrosis factor‐α does not seem to be the mediator of this impairment. Further studies are needed to evaluate the impact of H. pylori eradication on parameters of liver function.
Gut mucosal uptake and retention characteristics contribute to the high intestinal selectivity of budesonide compared with prednisolone in the rat
Authors: Miller‐Larsson A. , Gustafsson B. , Persson C. G. A. , Brattsand R. 
Published: March 2003

Background:Budesonide and prednisolone are both effective for the treatment of inflammatory bowel disease, but budesonide produces fewer adverse systemic effects. High first‐pass hepatic inactivation of budesonide partially explains its favourable ratio between topical and systemic activity, but it is probable that its uptake and retention in intestinal target tissues are also contributory.Aim:To compare the uptake and retention of radio‐labelled budesonide and prednisolone in rat ileal mucosa in vivo.Methods: 3H‐Budesonide and 3H‐prednisolone were applied for 10 min directly to a perfused segment of rat ileum in vivo, followed by saline lavage every 10 min. Steroid uptake into the mucosa and submucosa was assessed at 20 min and 4 h. The uptake of budesonide was also measured in allergen‐challenged animals vs. saline‐challenged controls to assess whether inflammation of the mucosa with ongoing plasma exudation would impair its uptake.Results:Budesonide was better absorbed into ileal tissue (15‐fold at 20 min) than prednisolone and better retained (50‐fold at 4 h) after topical administration. The uptake of budesonide was not impaired by exudation processes following allergen challenge.Conclusions:The higher uptake and retention characteristics of budesonide in gut mucosa should contribute to its greater intestinal selectivity compared with that of prednisolone.
Low‐dose lansoprazole and clarithromycin plus metronidazole vs. full‐dose lansoprazole and clarithromycin plus amoxicillin for eradication of Helicobacter pylori infection
Authors: Bazzoli F. , Zagari R. M. , Pozzato P. , Fossi S. , Ricciardiello L. , Nicolini G. , De Luca L. , Berretti D. , Alampi G. , Di Pietro C. , Morelli P. , Roda E. 
Published: March 2003

Aim:To compare, in a randomized controlled trial, the efficacy and tolerability of two 1‐week triple therapies for Helicobacter pylori eradication.Methods:One hundred and thirty‐four consecutive patients with non‐ulcer dyspepsia and H. pylori infection were randomized to receive lansoprazole 30 mg once daily, clarithromycin 250 mg twice daily, and metronidazole 500 mg twice daily (LCM group), or lansoprazole 30 mg twice daily, clarithromycin 500 mg twice daily, and amoxicillin 1000 mg twice daily (LCA group). H. pylori status was assessed by rapid urease test, histology and 13C‐urea breath test before and after therapy.Results:At 3 months, H. pylori eradication (intention‐ to‐treat/per protocol analysis) was 92.4%/93.8% in the LCM group and 83.1%/85.7% in the LCA group (P=N.S.). Side‐effects were more frequently reported in the LCA group (37.9%) than in the LCM group (19.7%) (P < 0.05).Conclusions:In this open, randomized controlled trial, eradication of H. pylori by low‐dose lansoprazole and clarithromycin plus metronidazole was higher with significantly less side‐effects than by full‐dose lansoprazole and clarithromycin plus amoxicillin. This finding may be related to the stronger synergism of clarithromycin plus metronidazole, even at lower doses, than of clarithromycin plus amoxicillin. Considering the lower cost as well, LCM should be preferred to LCA in the eradication of H. pylori.
Bifidobacterium animalis strain DN‐173 010 shortens the colonic transit time in healthy women: a double‐blind, randomized, controlled study
Authors: Marteau P. , Cuillerier E. , Meance S. , Gerhardt M. F. , Myara A. , Bouvier M. , Bouley C. , Tondu F. , Bommelaer G. , Grimaud J. C. 
Published: March 2003

Background:A previous study has suggested that Bifidobacterium animalis DN‐173 010 shortens the colonic transit time in women.Aim:To confirm this effect and to determine whether modifications of the faecal bacterial mass and/or faecal secondary bile salts may be the explanation.Methods:A double‐blind, cross‐over study was performed. Thirty‐six healthy women were studied in four consecutive 10‐day periods. During periods 2 and 4, they ingested three 125 g cups per day of a fermented milk which was either a product containing B. animalis DN‐173 010 or a control without bifidobacteria. Periods 1 and 3 were run‐in and washout periods, respectively. The total and segmental colonic transit times were assessed using a pellet method. In 12 subjects, all stools were collected and analysed for pH, faecal weight, bacterial mass and bile acids.Results:The total and sigmoid transit times were significantly shorter during dosing with B. animalis compared to the control period. The other transit times, faecal weight, pH, bacterial mass and bile acids were not significantly affected.Conclusions: B. animalis DN‐173 010 shortens the colonic transit time in healthy women. This effect is not explained by modifications of the faecal bacterial mass or secondary bile acids.
An approach toHelicobacter pyloriinfection in the elderly
Authors: Pilotto A. , Malfertheiner P. 
Published: March 2003

The prevalence ofHelicobacter pyloriinfection increases with age world‐wide, reaching levels of 40–60% in asymptomatic elderly subjects and over 70% in elderly patients with gastroduodenal diseases. However, the percentage ofH. pylori‐positive elderly patients who are treated for their infection remains very low.Data are now available that demonstrate the benefit of curingH. pyloriinfection in elderly patients withH. pylori‐associated peptic ulcer disease and severe chronic gastritis. Furthermore, the cure ofH. pylorimay prevent the progression of intestinal metaplasia and gastric atrophy. New studies are needed to clarify the role of eradication in elderly patients with non‐ulcer dyspepsia and gastro‐oesophageal reflux disease and in those who use non‐steroidal anti‐inflammatory drugs.H. pyloriinfection may be easily diagnosed by histological evaluation, rapid urease test or culture performed on gastric biopsies taken during endoscopy. However, the biopsy site must be carefully selected in elderly patients. For non‐invasive monitoring ofH. pyloriinfection after treatment, the13C‐urea breath test has significantly higher accuracy than serology in the elderly; further studies are needed to clarify the role of theH. pyloristool antigen test in old age.One‐week proton pump inhibitor‐based triple therapy regimens, including clarithromycin, amoxicillin and/or nitroimidazoles, are highly effective and well tolerated in elderly patients. Low doses of both proton pump inhibitors and clarithromycin (in combination with standard doses of amoxicillin or nitroimidazoles) are sufficient. Low compliance and antibiotic resistance are the main factors related to treatment failure in old age.
General principles to enhance practice patterns in gastrointestinal endoscopy
Authors: Sonnenberg A. , Gavin M. W. 
Published: March 2003

Aim:To develop general rules on how to pursue a therapeutic goal of interventional endoscopy without getting lost in abundant details.Methods:The influences of various medical interventions on the survival of a patient with gastrointestinal haemorrhage are modelled by an influence diagram. Survival is the focal point of multiple influences affecting its overall strength. Any downstream influence can represent the focal point of other preceding upstream influences. The mathematics underlying the influence diagram are similar to those of a decision tree with some notable exceptions. Its formalism allows one to consider inhibitory and additive influences and to include in the same analysis non‐commensurable qualities, such as correct diagnosis, haemostasis or survival.Results:The analysis reveals five general rules. First, the large number of factors involved in successful endoscopy render the influence of each individual factor less important. Second, a single factor that exerts its influence on many subsequent factors tends to be associated with an overall greater relevance. Third, remote influences are of lesser relevance than those directly linked to the final outcome. Fourth, factors multiplied by several consecutive probabilities lose their influence. Fifth, endoscopists need to assess the relevance of individual factors with respect to the immediate goals of endoscopy, as well as the general goals of patient well‐being.Conclusions:The influence model of endoscopic haemostasis reveals several general principles that can be utilized as tools in endoscopy training.
Hiatal hernia is the key factor determining the lansoprazole dosage required for effective intra‐oesophageal acid suppression
Authors: Frazzoni M. , De Micheli E. , Grisendi A. , Savarino V. 
Published: March 2003

Background:Effective intra‐oesophageal acid suppression can be achieved with lansoprazole. The daily dosage could be influenced by the presence of hiatal hernia.Aim:To assess the lansoprazole daily dosage required to normalize oesophageal acid exposure in patients with and without hiatal hernia.Methods:Fifty patients with complications or atypical manifestations of gastro‐oesophageal reflux disease were given lansoprazole, 30 mg once daily. Three to four weeks after the start of treatment, patients underwent oesophageal pH monitoring while on therapy. If the results were still abnormal, the lansoprazole dosage was doubled and 24‐h pH‐metry was repeated 20–30 days thereafter.Results:A 30‐mg daily dosage of lansoprazole normalized oesophageal acid exposure in 70% of cases, whilst a 60‐mg daily dosage was necessary in the remainder: the two groups differed only in the presence of hiatal hernia (28% vs. 100%, respectively; P=0.000). Effective intra‐oesophageal acid suppression was obtained in all 25 patients without hiatal hernia with the 30‐mg daily dosage of lansoprazole.Conclusions:Hiatal hernia is the key factor determining the lansoprazole dosage required for effective intra‐oesophageal acid suppression in complicated and atypical gastro‐oesophageal reflux disease. High efficacy of a 30‐mg daily dosage of lansoprazole can be predicted in the absence of hiatal hernia.
Helicobacter pylori infection, anti‐cagA antibodies and peptic ulcer: a case–control study in Italy
Authors: Palli D. , Menegatti M. , Masala G. , Ricci C. , Saieva C. , Holton J. , Gatta L. , Miglioli M. , Vaira D. 
Published: March 2003

Aim:To evaluate the association between infection with specific strains of Helicobacter pylori and peptic ulcer in patients referred for upper gastrointestinal endoscopy.Methods:One thousand, six hundred and twenty‐six consecutive dyspeptic patients, referred to one Endoscopy Unit in Bologna, Italy, were enrolled. For each participant, a blood sample was obtained for the measurement of distinct immunoglobulin G antibodies against H. pylori lysate and cytotoxin associated gene A (cagA). A case–control study included the whole series: patients diagnosed with duodenal (n=275) or gastric (n=71) ulcer were identified and independently compared with controls with non‐ulcer dyspepsia (n=1280).Results: H. pylori seroprevalence (at least one positive marker) was associated with increasing age, male sex and a diagnosis of peptic ulcer. This association was stronger with duodenal ulcer (multivariate odds ratio (OR), 5.2; 95% confidence interval (CI), 3.5–7.9) than with gastric ulcer (OR, 2.3; 95% CI, 1.2–4.4). Further analyses showed that H. pylori lysate+/cagA− subjects had a moderately increased risk of duodenal (OR, 3.2), but not gastric (OR, 1.1), ulcer. When cagA+ subjects were separately compared with seronegative patients, there was a six‐fold increased risk for duodenal ulcer and a three‐fold increased risk for gastric ulcer.Conclusions:A strong positive association between infection with a cagA+ H. pylori strain and the presence of peptic disease was found. The seroprevalence of anti‐cagA antibodies among patients with non‐ulcer dyspepsia is so high (41%) to preclude its use as a pre‐endoscopic screening test.
Low‐salt bowel cleansing preparation (LoSo Prep) as preparation for colonoscopy: a pilot study
Authors: Verghese V. J. , Ayub K. , Qureshi W. , Taupo T. , Graham D. Y. 
Published: March 2003

SummaryBackground : Currently available colon cleansing preparations are often poorly tolerated.Aim : To evaluate the efficacy of a low‐volume, low‐salt preparation for colonoscopy.Methods : This was a pilot study in patients scheduled for colonoscopy. The preparation consisted of 34 g of magnesium citrate and four bisacodyl tablets the day before the procedure, and one bisacodyl suppository on the morning of the procedure.Results : Twenty patients (age range, 49–81 years; all males) were entered into the study. There were no significant side‐effects associated with the preparation. All rated the taste as ‘tolerable or better’. The examination was considered to be adequate, with no limitations, in 17 patients (85%), and was scored as good to excellent (no solid stool) in 11 (55%), acceptable (small amounts of solid stool) in six (30%) and poor in three (15%: two in‐patients and one out‐patient). Importantly, two of the failures then received a standard polyethylene glycol preparation and again failed to show adequate colon preparation.Conclusions : This pilot study showed that the low‐salt colon cleansing preparation was an effective alternative preparation for colonoscopy.
Dose ranging pharmacokinetic trial of high‐dose alicaforsen (intercellular adhesion molecule‐1 antisense oligodeoxynucleotide) (ISIS 2302) in active Crohn's disease
Authors: Yacyshyn B. R. , Barish C. , Goff J. , Dalke D. , Gaspari M. , Yu R. , Tami J. , Dorr F. A. , Sewell K. L. 
Published: March 2003

SummaryBackground and aims : To evaluate the safety, pharmacokinetics and clinical efficacy of the intercellular adhesion molecule‐1 antisense phosphorothioate oligonucleotide alicaforsen (ISIS 2302) at 250–350 mg in Crohn's disease.Methods : Patients (> 50 kg) with active Crohn's disease (Crohn's disease activity index ≥ 220) were assigned by gender, randomly, to two alicaforsen treatment groups: 300 or 350 mg, infused intravenously three times a week for 4 weeks. All patients weighing 36–50 kg received 250 mg of alicaforsen. Background aminosalicylates, antibiotics, immunosuppressives and corticosteroids were permitted, but tumour necrosis factor‐αinhibitors were prohibited. The primary end‐point wasclinical remission (Crohn's disease activity index ≤ 150).Results : Twenty‐two patients were enrolled with a mean baseline Crohn's disease activity index of 304. Steroids were used by 27%, 5‐aminosalicylic acid by 68% and immunosuppressives by 27%; 23% had previously received infliximab. Five subjects withdrew after one to three infusions for infusion‐related symptoms. Nine patients (41%) experienced clinical remission. Fifty‐three per cent of the evaluable subjects receiving more than three infusions experienced remission (18% at week 8; 29% at week 12). The overall response, using a minimum decrease of 70 in the Crohn's disease activity index, was 41–47% for the evaluable group, at weeks 8 and 12. The median duration of remission was 14 weeks. Plasma pharmacokinetic results showed overlapping levels (Cmax, AUC) for the three doses. The infusion‐related reaction profile consisted of fever, chills, headache, nausea, emesis or arthralgias, typically occurring 2–4 h after completion of the first infusion. Reactions were less frequent in patients receiving background corticosteroids. The 2–4‐h transient post‐infusion partial thromboplastin time prolongation values, a class effect of phosphorothioate oligonucleotides, were 18, 21 and 23 s for 250, 300 and 350 mg, respectively.Conclusions : Alicaforsen (ISIS 2302), at fixed doses of 300 and 350 mg, achieved the desired drug exposure and may be an effective therapy for Crohn's disease. Infusion‐related reactions were observed less frequently in patients on corticosteroids, and with decreasing frequency with continued treatment.