bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effects of oral rabeprazole on endocrine and gastric secretory function in healthy volunteers
Authors: Dammann  , Burkhardt  , Wolf  
Published: March 2003

Aim: To evaluate the short‐term effects of rabeprazole 20 mg on endocrine parameters, in particular serum testosterone and cortisol, and on 24 h intragastric pH, H+ activity and nocturnal gastric acid secretion.Methods: In this double‐blind, two‐period crossover study, 12 healthy young male volunteers were randomly given oral rabeprazole 20 mg o.m. or placebo for 14 days. There was a washout period of at least 1 week between the two studies. The effects of rabeprazole and placebo on cortisol and testosterone (primary criteria), and on tri‐iodothyronine, thyroxine, 17β‐oestradiol, thyroid‐stimulating hormone, thyroxine‐binding protein, parathyroid hormone, insulin, glucagon, rennin, aldosterone, follicle‐stimulating hormone, luteotrophic hormone, prolactin, somatotrophic hormone, dehydroepiandrosterone, cortisol‐binding globulin and urinary 6‐β hydroxycortisol were compared. Intragastric 24 h pH, 24 h H+ activity and nocturnal gastric acid secretion were determined by pH probe and gastric aspiration.Results: Rabeprazole produced no clinically relevant effects on endocrine function as assessed by measurement of serum testosterone, circadian serum cortisol levels, ACTH‐stimulated serum cortisol levels and 17 other endocrine function tests. Rabeprazole significantly increased the 24 h median pH values compared to placebo (on Days 7 and 14 median values ranged from 3.92 to 6.88 with rabeprazole and from 1.48 and 4.22 with placebo, P < 0.001) and significantly decreased the integrated 24 h H+ activity (AUC08–08) from 343 mmol/L/h with placebo to 44 mmol/L/h with rabeprazole (P < 0.001). Following cessation of dosing, intragastric pH levels decreased and H+ activity increased, but acid secretion did not recover completely during the next 72 h. The mean value for nocturnal gastric acid secretion on Days 7 and 8 was 36 mmol/6 h with placebo and 5.6 mmol/6 h with rabeprazole (P < 0.001). Rabeprazole was well tolerated.Conclusion: Rabeprazole did not influence endocrine function in healthy young male volunteers during short‐term dosing. Rabeprazole substantially increased intragastric pH over a 24 h period and significantly decreased intragastric acidity and nocturnal gastric acid secretion.
Lansoprazole in the treatment of heartburn in patients without erosive oesophagitis
Authors: Richter J. E. , Kovacs T. O. G. , Greski‐Rose P. A. , Huang B. , Fisher R. 
Published: March 2003

Background: This randomized, double‐blind, multicentre study compared lansoprazole with placebo for symptomatic relief of patients with non‐erosive gastro‐oesophageal reflux disease (GERD).Methods: 214 patients with symptomatic, non‐erosive GERD (moderate to severe daytime and/or night‐time heartburn greater than half the days over the past 6 months and during the 7‐ to 10‐day pre‐treatment period) were randomized to either lansoprazole 15 mg or lansoprazole 30 mg, or placebo o.d. for 8 weeks.Results: Daily diary data indicated that on the first treatment day a statistically significantly smaller percentage of lansoprazole patients reported daytime and night‐time heartburn and antacid usage, compared with placebo patients. Lansoprazole patients also reported statistically significant less severe daytime and night‐time heartburn on the first treatment day. During 0–4, 4–8, and 0–8 weeks of therapy, a statistically significant smaller percentage of days and nights with heartburn, less severe daytime and night‐time heartburn, and less antacid usage were observed in the lansoprazole group compared to the placebo group. The percentages of patients with adverse reactions were similar in the lansoprazole and placebo groups.Conclusions: The results of this study demonstrate that lansoprazole is an appropriate therapy for patients with symptomatic non‐erosive GERD.
Dilatation and constriction of rat gastric mucosal microvessels through prostaglandin EP2 and EP3 receptors
Authors: Ohno  , Katori  , Majima  , Saeki  , Boku  , Nishiyama  , Hayashi  , Saigenji  
Published: March 2003

Background: Prostaglandin (PG)E2 has both a vasodilating action and a protective function in the gastric mucosa. There are four subtypes of PGE2‐sensitive, or EP, receptors.Aim: To identify the subtype of EP receptors in the microvessels of the rat gastric mucosa using EP2 and EP3 receptor agonists.Methods: The posterior wall of the anaesthetized rat stomach was secured in a chamber and superfused with Tyrode’s solution, and the gastric microcirculation of the mucosal base was observed through a window with transillumination. PGE2 and its derivatives (20 μL) were applied topically in the window.Results: PGE2 (0.001–10 μmol/L), misoprostol (EP2/EP3 receptor agonist; 0.01–100 μmol/L) and butaprost (EP2 receptor agonist; 1–1000 μmol/L) dilated the arterioles dose‐dependently, but M&B 28 767 (EP3 receptor agonist; 0.001–10 μmol/L) did not alter their diameters. M&B 28 767 constricted the venules and collecting venules dose‐dependently whereas butaprost dilated them. PGE2 and misoprostol had bell‐shaped dose–response curves: constriction by low doses of PGE2 and misoprostol (0.001–0.1 μmol/L and 0.01–1 μmol/L) and dilation by high doses of PGE2 and misoprostol (0.1–100 μmol/L and 1–100 μmol/L).Conclusions: These results suggest that PGE2 dilated both arterioles and venules in the rat gastric mucosa through the EP2 receptors and constricted the venules through the EP3 receptors.
Review article: nonsteroidal anti‐inflammatory drug‐associated gastrointestinal complications—guidelines for prevention and treatment
Authors: Schoenfeld  , Kimmey  , Scheiman  , Bjorkman  , Laine  
Published: March 2003

Chronic ingestion of NSAIDs increases the risk for gastrointestinal complications, which range from dyspepsia to gastrointestinal bleeding, obstruction, and perforation. Among patients using NSAIDs, 0.1 to 2.0% per year suffer serious gastrointestinal complications. Patients who require analgesic therapy should be carefully assessed for the lowest possible dosage and shortest duration of NSAID use and for the potential of treatment with a non‐NSAID pain reliever. These patients should also be assessed for factors that increase their risk of gastrointestinal complications, including increased age, concomitant anticoagulant or corticosteroid use, and past history of NSAID‐associated gastrointestinal complications.The exact association between Helicobacter pylori infection and NSAID‐related ulcer disease is unclear, and the routine testing and treatment of all NSAID using patients for H. pylori infection is not recommended at this time. NSAID‐using patients who suffer from dyspepsia should have NSAIDs discontinued, the dosage changed, or be changed to a different class of NSAID. If NSAIDs cannot be discontinued, then an antisecretory agent should be initiated. Misoprostol prevents NSAID‐associated gastrointestinal complications. Proton pump inhibitors are the most effective at healing NSAID‐associated ulcers among patients who cannot discontinue NSAID therapy.
Review article: acid suppression in non‐variceal acute upper gastrointestinal bleeding
Authors: Barkun  , Cockeram  , Plourde  , Fedorak  
Published: March 2003

Despite a decreased incidence of ulcer disease and improvements in the management of acute upper gastrointestinal (GI) bleeding, mortality remains at about 6–7%. Although endoscopic haemostatic therapy has been demonstrated to be the mainstay of management, the search continues for less invasive medical modalities that might also improve patient outcome. In vitro data have indicated the important role of acid in impairing haemostasis and causing clot digestion. Therefore, theoretically, maintenance of a high intragastric pH (above 6.0) during management of upper GI bleeding is warranted. Until recently, available agents did not permit such a sustained elevation in gastric pH. Early studies with H2‐receptor antagonists have not demonstrated significant improvements in important patient outcomes, such as rebleeding, surgery or mortality.With the availability of intravenous formulations of proton pump inhibitors, it is now possible to aim at maintaining gastric pH above 6.0 for 24 h per day. Recent clinical trial data would appear to support the use of proton pump inhibitors to decrease the rate of rebleeding and the need for surgery. This paper provides a review of non‐variceal acute GI bleeding, with special reference to the role of proton pump inhibitors in this clinical setting.
Inactivated hepatitis A vaccine in Chinese patients with chronic hepatitis B infection
Authors: Tsang  , Sung  
Published: March 2003

Background: Hepatitis B (HBV)‐infected patients have a higher morbidity and mortality when super‐infected by hepatitis A (HAV).Aim: To evaluate the immunogenicity and safety of a commercial inactivated HAV vaccine in Chinese patients with chronic HBV infection.Methods: Sixty‐five HBV‐infected patients (30 carriers, 22 chronic hepatitis, 13 cirrhosis), who were seronegative for HAV, received a dose of 1440 ELISA units of HAV vaccine at weeks 0 and 24. Twenty‐eight healthy individuals aged 18–57 years, who were seronegative for both HBV and HAV infection, also received the same vaccination regimen. Seroconversion was defined as an anti‐HAV titre ≥ 33 mIU/mL.Results: The seroconversion rates for the HBV‐infected patients at weeks 2, 4 and 24 were 72, 91 and 80%, respectively. The corresponding geometric mean titres (GMTs) were 103, 311 and 123 mIU/mL. In the healthy control group the seroconversion rates were 86, 93 and 89% at weeks 2, 4 and 24. The corresponding GMTs were 112, 158 and 250 mIU/mL. There was no difference in the seroconversion rates between the two groups, but healthy controls had a significantly higher GMT at week 24 (P=0.04). Side‐effects were more common in HBV patients.Conclusion: The HAV vaccine is equally efficacious in patients with chronic HBV infection.
Rectal and colonic mesalazine concentration in ulcerative colitis: oral vs. oral plus topical treatment
Authors: Frieri  , Pimpo  , Palumbo  , Onori  , Viscido  , Latella  , Galletti  , Pantaleoni  , Caprilli  
Published: March 2003

Aim: To measure mucosal concentrations of mesalazine in ulcerative colitis patients treated with oral mesalazine alone, compared to patients treated with both topical and oral mesalazine.Methods: Twenty‐two patients with mild to moderate ulcerative colitis were randomized to receive 2.4 g/day of oral mesalazine (11 patients) or 2.4 g/day oral plus 4 g/day of topical mesalazine (11 patients). After 2 weeks of treatment, endoscopic biopsies specimens were taken from the rectum and in descending colon just distal of the splenic flexure and stored to –80 °C for later assay (HPLC). Wilcoxon’s rank sum test for unpaired data was used for the statistical analysis.Results: Mucosal levels of mesalazine in the rectum were significantly higher in patients who received oral plus topical treatment than in those who had oral treatment alone (52.1 ng/mg, range: 13.6–122.1 vs. 0.2 ng/mg, range: 0.2–9.7, respectively; P < 0.0001). Similarly, in the descending colon, the mucosal concentrations of mesalazine were significantly higher in patients who had oral plus topical treatment than in those receiving oral treatment alone (46.6 ng/mg, range: 6–112.6 vs. 15.9 ng/mg, range: 2.3–42.4, respectively; P=0.01).Conclusions: Topical treatment of mesalazine significantly increases mucosal concentrations of mesalazine up to the splenic flexure, supporting the rationale to treat left‐sided ulcerative colitis with topical formulations of mesalazine.
The efficacy of octreotide therapy in chronic bleeding due to vascular abnormalities of the gastrointestinal tract
Authors: Nardone  , Rocco  , Balzano  , Budillon  
Published: March 2003

Background: The treatment of angiodysplasia and watermelon stomach, vascular abnormalities implicated in gastrointestinal bleeding of obscure origin, is a major clinical problem.Aim: To determine the efficacy of octreotide in patients with long‐standing gastrointestinal bleeding due to acquired angiodysplasia and watermelon stomach, resistant to previous treatments and not suitable for surgery because of old age and/or concomitant disorders.Patients and methods: We treated 17 patients (seven had isolated angiodysplasia, seven had multiple upper and lower gastrointestinal angiodysplasia, and three had watermelon stomach) with octreotide (0.1 mg subcutaneous t.d.s. for 6 months). Six of the patients had liver cirrhosis, one had Glanzmann‐type platelet derangement, two had cardiovascular diseases and one had chronic uraemia.Results: Octreotide treatment stopped bleeding in 10 patients. A transient improvement was observed in four, who needed subsequent cyclical retreatment to correct low haemoglobin levels. No effect was observed in three, probably due to the severity of the concomitant disorders.Conclusions: Octreotide is a safe drug that may be useful to control the recurrent gastrointestinal bleeding due to acquired angiodysplasia and watermelon stomach, especially in patients who are not candidates for surgery due to old age and/or concomitant disorders.
Standard‐dose lansoprazole is more effective than high‐dose ranitidine in achieving endoscopic healing and symptom relief in patients with moderately severe reflux oesophagitis
Authors: Jansen  , Van Oene  ,   ON BEHALF OF THE DUTCH LANSOPRAZOLE STUDY GROUP
Published: March 2003

Background:In the treatment of reflux oesophagitis, H2‐receptor antagonists are still widely used in spite of the apparent higher efficacy of proton pump inhibitors. In an attempt to compensate for the lower efficacy, H2‐receptor antagonists are now increasingly being used at a higher dose.Objective:To assess whether or not standard‐dose lansoprazole (30 mg o.d.) is more effective than high‐dose ranitidine (300 mg b.d.) in moderately severe reflux oesophagitis (grades II–III).Methods:Lansoprazole or ranitidine was given to 133 patients for 4–8 weeks in a double‐blind, randomized, parallel group, multicentre trial.Results:The percentage of patients with endoscopically‐verified healing was significantly higher on lansoprazole than on ranitidine both after 4 weeks (79% vs. 42%) and 8 weeks (91% vs. 66%), though smoking had a negative impact on oesophagitis healing with lansoprazole. Heartburn, retrosternal pain and belching improved significantly better with lansoprazole than with ranitidine, as did the patient‐rated overall symptom severity. Relief of heartburn appeared somewhat faster with ranitidine, but was more pronounced with lansoprazole. The number of patients with adverse events was similar in both treatment groups.Conclusion:Standard‐dose lansoprazole is better than high‐dose ranitidine in moderately severe reflux oesophagitis.
Treatment of Helicobacter pylori: an overview
Authors: Axon A. T. R. 
Published: March 2003

Summary Helicobacter pylori is recognized to be a serious pathogen, but there is still controversy as to who should be treated. There is consensus for treatment of Helicobacter‐positive peptic ulcer and B‐cell lymphoma. Lymphocytic gastritis and giant‐fold gastritis (Ménétrièr's disease) may also respond to treatment. Patients with func‐tional dyspepsia have a 20% placebo response with a 5–10% ‘eradication’ response, results not dissimilar from empirical treatment with a proton pump inhibitor. A ‘test and treat’ policy for patients with uninvesti‐gated dyspepsia remains controversial. Some have suggested that eradication may increase the risk of GERD, or predispose to adenocarcinoma at the gastro‐oesophageal junction. However, PPI treatment without Helicobacter eradication induces greater inflammation in the gastric corpus, the phenotype associated with non‐cardia gastric cancer. A minority believe that Helicobacter should be eradicated in all individuals.When choosing treatment it is logical to start with a combination of antibiotics that, in the event of failure, will allow a second combination to be used without overlap.
The continuing dilemma of dyspepsia
Authors: Stanghellini V. , Tosetti C. , Barbara G. , De Giorgio R. , Salvioli B. , Corinaldesi R. 
Published: March 2003

SummaryDyspepsia drains a substantial proportion of healthcare resources in industrialized countries and an appropriate management strategy is needed. An aetiological role for Helicobacter pylori infection has been demonstrated in a number of pathological conditions associated with dyspepsia, such as peptic ulcer and gastric malignancies, but not in functional dyspepsia. Endoscopy and diagnosis‐based treatment, H. pylori testing and eradication therapy, history taking and empirical therapy, are the main tools that are currently available for managing patients with upper gastrointestinal symptoms. Endoscopy identifies malignancies and organic diseases of the proximal gut and therefore provides reassurance to both doctors and patients. It should be recommended in older patients with suspicious symptoms and it has proven to be more cost‐effective than empirical H2‐receptor antagonists in patients with ulcer‐like symptoms. Empirical eradication in all dyspeptics without suspicious symptoms is a cost‐effective approach that cures the majority of peptic ulcers. Nevertheless, it does not control symptoms in the majority of patients, it may exacerbate gastro‐oesophageal reflux disease, and it encourages antibiotic resistance. The realities of current clinical practice require empirical therapy in most, if not all, the dyspeptics seen by general practitioners. A detailed history taking can help to diagnose gastro‐oesophageal reflux disease and to identify suspicious symptoms. Furthermore, identification of dyspepsia subgroups may provide guidance for empirical therapy. Nevertheless, even analysis of individual symptoms does not provide a sufficient diagnostic yield to differentiate functional from organic dyspepsia and appropriate investigations are needed in patients with poor response to short‐term therapy or frequent relapses.
Omeprazole or ranitidine bismuth citrate triple therapy to treat Helicobacter pylori infection: a randomized, controlled trial in Vietnamese patients with duodenal ulcer
Authors: Mao  , Lak  , Long  , Chung  , Thang  , Hop  , Chien  , Hoan  , Henley  , Perez‐Perez  , Connor  , Stone  , Chey  
Published: March 2003

Aim:To evaluate the effectiveness of triple therapy containing either omeprazole or ranitidine bismuth citrate (RBC) to treat H. pylori infection in Vietnamese duodenal ulcer patients.Methods:Patients infected with H. pylori were randomized to receive either omeprazole (20 mg b.d.), clarithromycin (500 mg b.d.) and amoxycillin (1 g b.d.) for 10 days (OAC), or RBC (400 mg b.d.), clarithromycin (500 mg b.d.) and amoxycillin (1 g b.d.) for 10 days (RAC). H. pylori eradication and ulcer healing was established by a follow‐up oesophagogastroduodenoscopy (EGD) at least 4 weeks after therapy. Side‐effects and compliance were assessed.Results:One hundred and four out of 108 (96%) patients with a duodenal ulcer were infected with H. pylori. Eighty per cent of infected patients had detectable CagA IgG antibodies. Fifty‐seven patients received OAC and 47 received RAC. OAC eradicated H. pylori in 91 and 86% of patients by per protocol (PP) and intention‐to‐treat (ITT) analysis, respectively. PP and ITT eradication rates for RAC were 96 and 91%. Ulcer healing at the follow‐up EGD was 89% with OAC and 100% with RAC. Side‐effects were minor. No patient failed to complete the protocol due to side‐effects.Conclusion:Triple therapy with either omeprazole or RBC is highly effective in eradicating H. pylori and healing duodenal ulcer in Vietnamese patients.
Seven‐day triple therapy with ranitidine bismuth citrate or omeprazole and two antibiotics for eradication of Helicobacter pylori in duodenal ulcer: a multicentre, randomized, single‐blind study
Authors: Spinzi  , Boni  , Bortoli  , Colombo  , Ballardini  , Venturelli  , Minoli  
Published: March 2003

Aim:To investigate the efficacy of a 1‐week triple therapy with amoxycillin, clarithromycin, and omeprazole or ranitidine bismuth citrate (RBC) in curing Helicobacter pylori infection and healing duodenal ulcers.Methods:One hundred and ninety‐two consecutive out‐patients with duodenal ulcer, in whom H. pylori infection was confirmed by histology and a urease biopsy test, were randomly assigned to a 1‐week treatment with either 400 mg b.d. ranitidine bismuth citrate (RAC group) or 20 mg omeprazole b.d. (OAC group) in combination with 1 g amoxycillin b.d. and 500 mg clarithromycin b.d.Results:Eradication of H. pylori was successful in 77% (per protocol) and 61% (intention‐to‐treat) of the patients in the RAC group and in 79% (per protocol) and 70% (intention‐to‐treat) of those in the OAC group. The difference was not significant. Per protocol analysis showed ulcers were healed in 97% of patients in the RAC group and 96% in the OAC group. Adverse effects were seen in four patients in each group: they caused discontinuation of the therapy in one patient of the OAC group.Conclusions:Eradication rates obtained in this study were lower than those expected on the basis of previously reported studies. The two 1‐week treatment regimens were equally effective in healing H. pylori associated duodenal ulcer disease.
Interferon alfa‐2b plus ribavirin for chronic hepatitis C patients who have not responded to interferon monotherapy
Authors: Lo Iacono  , Castro  , Diago  , Moreno  , Fernandez‐Bermejo  , Vega  , García  , Carbonell  , Sanz  , Borque  , García‐Buey  , García‐Monzón  , Pedreira  , Moreno‐Otero  
Published: March 2003

Background:The role of combination therapy is poorly defined in chronic hepatitis C patients who are non‐responders to interferon.Aim:To assess the efficacy, safety and tolerance of interferon alfa‐2b plus ribavirin in chronic hepatitis C patients who do not respond to interferon monotherapy.Methods:A total of 127 non‐responder patients with chronic hepatitis C received 3 mU t.i.w. of interferon alfa‐2b plus 1000–1200 mg ribavirin daily for 48 weeks. Effects of therapy were evaluated by serum aminotransferases and hepatitis C virus (HCV) RNA levels.Results:Twenty‐nine (23%) patients had an end‐of‐treatment response. Six months after treatment, 20 (16%) patients were sustained responders. Early loss of HCV RNA was the strongest predictor of a sustained response (P < 0.0001). Remission was also more frequent in patients with genotype 1b (P < 0.02), elevated alanine aminotransferase (P < 0.03) and low gamma glutamiltranspeptidase (P < 0.002). Treatment was discontinued in 21 (17%) patients: in 14 for intolerance and in seven due to side‐effects.Conclusions:Combination therapy with interferon plus ribavirin produced a sustained response in 16% of chronic hepatitis C patients who were non‐responders to interferon. This combination was safe and well tolerated.