bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accuracy of the stool antigen test in the diagnosis of Helicobacter pylori infection before treatment and in patients on omeprazole therapy
Authors: Manes G. , Balzano A. , Iaquinto G. , Ricci C. , Piccirillo M. M. , Giardullo N. , Todisco A. , Lioniello M. , Vaira D. 
Published: March 2003

Aim:To evaluate the Helicobacter pylori stool antigen (HpSA) test in the assessment of H. pylori infection and the effect of omeprazole treatment on its accuracy.Methods: Study 1: 140 dyspeptic patients were enrolled in the study and defined as H. pylori positive if histology and rapid urease test, or culture alone were positive. HpSA was performed on all patients and 13C‐urea breath test (UBT) on 87. Study 2: 75 patients testing positive using both UBT and HpSA, were given omeprazole 20 mg for 2 weeks (Group A) or omeprazole 40 mg for 2 weeks (Group B), or OAC for 1 week (group C). A Helicobacter pylori stool antigen test was performed on all patients on days 3, 5, 7 and 14 during treatment, and also on days 7 and 14 post‐treatment in groups A and B. UBT was performed in groups A and B on days 7 and 14 during treatment, and days 7 and 14 post‐treatment.Results:80/140 patients were H. pylori positive. The sensitivity and specificity of HpSA were 93.8 and 90%, similar to UBT (93.9 and 92.1%). Omeprazole significantly reduced both HpSA and UBT values, resulting in a decreased accuracy. Of 25 patients receiving 20 mg omeprazole, HpSA gave 5 and 6 false negatives after 7 and 14 days treatment respectively, while UBT gave 4 and 7 false negatives after 7 and 14 days treatment. Of 25 patients receiving 40 mg omeprazole, HpSA gave 7 and 9 false negatives after 7 and 14 days of treatment, while UBT gave 8 and 9 false negatives after 7 and 14 days of treatment. Two weeks after stopping omeprazole treatment, the HpSA and UBT were positive in all cases.Conclusions:The Helicobacter pylori stool antigen test is valuable in the assessment of H. pylori infection. Short‐term omeprazole treatment decreases the accuracy of both HpSA and UBT in a similar manner.
Involvement of cyclooxygenase‐2 in hyperplastic gastritis induced by Helicobacter pylori infection in C57BL/6 mice
Authors: Xiao F. , Furuta T. , Takashima M. , Shirai N. , Hanai H. 
Published: March 2003

Background and aims:The hyperplastic changes observed in Helicobacter pylori‐associated gastritis have been considered to increase the risk of gastric cancer. The aim of this study was to determine whether cyclooxygenase‐2 is involved in the hyperplastic changes in mice infected with H. pylori.Methods:Seven‐week‐old, male C57BL/6 mice (n=40) were inoculated with the Sydney strain of H. pylori. Control mice (n=40) were treated with vehicle only. Half of the infected and control mice were fed an experimental diet containing etodolac (10 mg/kg/day) from 1 week after inoculation until the end of the experiment. The thickness of gastric pits, COX‐2 mRNA and protein levels, and prostaglandin E2 (PGE2) levels in the gastric mucosa were determined before and 12, and 24 weeks after inoculation.Results:The thickness of gastric pits, COX‐2 mRNA and protein levels, and PGE2 levels were significantly increased at 24 weeks after inoculation of H. pylori compared with the control groups. Treatment with etodolac resulted in significant decreases in PGE2 production and in the thickness of gastric pits in the infected groups at 24 weeks after inoculation.Conclusions:Our findings suggest that COX‐2 is involved in the development of hyperplastic gastritis caused by H. pylori infection via the production of PGE2.
A systematic comparison of triple therapies for treatment of Helicobacter pylori infection with proton pump inhibitor/ ranitidine bismuth citrate plus clarithromycin and either amoxicillin or a nitroimidazole
Authors: Janssen M. J. R. , Van Oijen A. H. A. M. , Verbeek A. L. M. , Jansen J. B. M. J. , De Boer W. A. 
Published: March 2003

Background:Triple therapies with proton pump inhibitor/ranitidine bismuth citrate (RBC), clarithromycin (C) and either amoxicillin (A) or a nitroimidazole (I) are widely accepted as treatment for Helicobacter pylori infection. However, it is not clear which of these antibiotic combinations should be preferred.Aim:To evaluate whether there is a difference in efficacy between triple therapies with proton pump inhibitor/RBC, clarithromycin and either amoxicillin or a nitroimidazole.Methods:The literature was examined for randomized trials comparing proton pump inhibitor/RBC‐C‐A and proton pump inhibitor/RBC‐C‐I. Studies were grouped according to the type of acid inhibitor used (proton pump inhibitor or RBC) and differences between pooled cure rates were calculated.Results:Forty‐seven studies were identified: seven using RBC, 39 using proton pump inhibitor, one using both. RBC‐C‐I was somewhat superior to RBC‐C‐A, although this difference only reached statistical significance in intention‐to‐treat analysis. Overall, proton pump inhibitor‐C‐I and proton pump inhibitor‐C‐A were equally effective, but in nitroimidazole‐susceptible strains, proton pump inhibitor‐C‐I performed better, in nitroimidazole‐resistant strains, proton pump inhibitor‐C‐A performed better. No serious side‐effects were reported and pooled drop‐out rates were equal.Conclusions:In general, proton pump inhibitor‐C‐I and proton pump inhibitor‐C‐A are equally effective and therefore other factors such as local prevalence of resistant strains, cost of therapy and options for second‐line treatment should determine which regimen should be preferred. When using RBC, the RBC‐C‐I combination is somewhat superior to RBC‐C‐A.
Ten‐year combination treatment with colchicine and ursodeoxycholic acid for primary biliary cirrhosis: a double‐blind, placebo‐controlled trial on symptomatic patients
Authors: Battezzati P. M. , Zuin M. , Crosignani A. , Allocca M. , Invernizzi P. , Selmi C. , Villa E. , Podda M. 
Published: March 2003

Background:Combined medical treatment may provide further benefit to primary biliary cirrhosis (PBC) patients administered ursodeoxycholic acid (UDCA).Aim:To evaluate the long‐term effects of colchicine and UDCA in symptomatic PBC patients.Patients/methods:We extended up to 10 years the double‐blind treatment of 44 symptomatic PBC patients originally included in a 3‐year multicentre study comparing UDCA and colchicine (U + C) versus UDCA and placebo (U + P). Outcome measures were death or liver transplantation; incidence of clinically relevant events; clinical and quantitative variables retaining prognostic information.Results:Mean follow‐up was 7 ± 3 years. One patient was lost, three withdrew because of jaundice (U + P); two patients stopped colchicine but remained on UDCA. Eleven patients (two for liver‐unrelated reasons, U + P) and six patients (U + C) died, three and two patients, respectively, were transplanted (incidence rate difference, five cases per 100 patient‐years; 95% CI, −1 to 11). Hepatocellular carcinoma developed in one (U + P) and four (U + C) patients (difference, −2; CI, −5 to 1), portal hypertension complications in nine patients from each group (difference, 1; CI, −5 to 6). Trends of serum bilirubin, Mayo score, antipyrine clearance were similar among treatment groups.Conclusions:In cirrhotic PBC patients, colchicine does not offer additional benefits to UDCA. In this population, UDCA does not obviate disease progression.
Immune sensitization to food, yeast and bacteria in Crohn’s disease
Authors: Van Den Bogaerde J. , Kamm M. A. , Knight S. C. 
Published: March 2003

Background:Complex food proteins and enteric flora may act as antigenic stimuli in Crohn’s disease. This study assessed the prevalence and magnitude of lymphocyte priming to these antigens in Crohn’s disease.Methods:A total of 31 Crohn’s disease patients (median age 42 years, range 25–72 years) and 22 healthy controls (median 29 years, 23–43 years) were studied. Peripheral blood lymphocytes were collected and incubated with antigens in hanging drop culture for 4 days. The antigens tested were cow’s milk, cereals, cabbage group, citrus group, peanut group, Saccharomyces (yeast), Bacteroides, E. coli and Klebsiella. On the 4th day 3H‐thymidine incorporation was measured after a 4‐h pulse. Responses to antigens were considered positive if mean proliferative values were above the 99% confidence interval for background proliferation.Results:The mean background and mitogen‐stimulated proliferation did not differ between patients and controls. The mean proliferation to antigens was not above background in controls, but in Crohn’s patients proliferative responses to all food and bacterial antigens were significantly higher than background values. Twenty‐three out of 31 Crohn’s patients and five out of 22 controls (P=0.0003) responded to one or more antigens. Sixteen Crohn’s patients and two controls responded to four or more antigens (P=0.001, Fisher’s exact test).Conclusion:The reactivity of peripheral lymphocytes to food, yeast and bacterial antigens, especially multiple antigens, is common in Crohn’s disease. These sensitized lymphocytes may contribute to the inflammatory process.
Balsalazide therapy in ulcerative colitis
Authors: Ragunath K. , Williams J. G. 
Published: March 2003

Balsalazide is a 5‐aminosalicylic acid (mesalazine) pro‐drug which has an inert carrier molecule instead of the sulfapyridine moiety of sulfasalazine. It is designed to deliver 5‐aminosalicylic acid to the colonic mucosa without the sulfapyridine‐associated side‐effects encountered with sulfasalazine.Several studies have confirmed the efficacy and patient tolerance of balsalazide. When compared to mesalazine at equivalent doses, it induced symptomatic and complete remission of acute ulcerative colitis in a greater proportion of patients. In particular, patients with resistant left‐sided disease were shown to have a higher probability of achieving remission. Balsalazide was beneficial in patients with troublesome nocturnal symptoms. It has a similar efficacy in maintaining remission when compared to sulfasalazine and mesalazine. The advantage of balsalazide over other 5‐aminosalicylic acid compounds is its superior patient tolerability with minimal side‐effects.
Effectiveness and safety of nizatidine, 75 mg, for the relief of episodic heartburn
Authors: Paul K. , Redman C. M. , Chen M. 
Published: March 2003

Background:The most frequent cause of episodic heartburn is food and beverage ingestion. Nizatidine, an H2‐receptor antagonist, is currently approved for non‐prescription use in the prevention and relief of heartburn at a dose of 75 mg up to twice a day.Methods:Two identical studies were carried out to evaluate the efficacy of nizatidine, 75 mg, compared with placebo in treating heartburn in an ‘at‐home’ setting. The studies were multicentre, multiple‐dose, placebo‐controlled, randomized, parallel group design. A total of 994 subjects were randomized to treatment. Adequate relief of heartburn was assessed at 15, 30 and 45 min and 1, 2 and 3 h following a treatment dose. A subject’s responses with respect to time to relief and attainment of adequate relief were combined into a derived response profile, the sustained adequate relief score. Adverse experiences were noted throughout the study period.Results:The individual and combined study results showed that nizatidine, 75 mg, relieved heartburn faster and/or more consistently than placebo. The mean sustained adequate relief score, calculated over a subject’s first four episodes, was 2.43 in the nizatidine‐treated group compared with 2.14 in the placebo group (P < 0.001). Nizatidine‐treated subjects attained sustained adequate relief in a significantly (P < 0.001) larger percentage (75%) of their heartburn episodes than did subjects treated with placebo (66%). No serious adverse experiences were associated with nizatidine treatment.Conclusion:Nizatidine, 75 mg, is a safe and effective treatment for episodic heartburn. The results showed that subjects taking nizatidine had heartburn relief that was achieved faster and/or more reliably than did subjects taking placebo.
Lansoprazole in children: pharmacokinetics and efficacy in reflux oesophagitis
Authors: Faure C. , Michaud L. , Khan Shaghaghi E. , Popon M. , Laurence M. , Mougenot J. F. , Hankard R. , Navarro J. , Jacqz‐Aigrain E. 
Published: March 2003

Background:Data on the proton pump inhibitor lansoprazole in paediatric patients are limited.Aim:To investigate the pharmacokinetics, optimal dosage and efficacy of lansoprazole in paediatric patients.Methods:A 24‐h gastric pH recording and a pharmacokinetic study were performed after 7 days of lansoprazole, 17 mg/m2, in 23 patients with reflux oesophagitis (median age, 3.5 years). Response was defined as pH > 3 for > 65% of the recording. The dosage was doubled in non‐responders. Patients with no response on day 14 were excluded. Responders underwent endoscopy after 4 weeks on the response‐inducing dosage; abnormal findings led to a repeat endoscopy after four additional weeks.Results:Nine patients responded to 17 mg/m2 and six to 30.3 mg/m2. On day 7, time with pH > 3 was significantly correlated with the area under the plasma concentration–time curve (P=0.003). The area under the plasma concentration–time curve was significantly greater in the nine responders to 17 mg/m2 than in the 14 other patients. Pharmacokinetic parameters were similar in responders and non‐responders to the higher dose. After 4 weeks, oesophagitis was healed in 80% of responders. Adverse events occurred in three patients and required treatment discontinuation in one.Conclusions:Lansoprazole is effective and safe in children. The optimal starting dosage is 30 mg/m2 or 1.4 mg/kg.
Long‐term lansoprazole control of gastric acid and pepsin secretion in ZE and non‐ZE hypersecretors: a prospective 10‐year study
Authors: Hirschowitz B. I. , Simmons J. , Mohnen J. 
Published: March 2003

Background:The majority of patients with Zollinger–Ellison syndrome require lifelong treatment with proton pump inhibitors.Aims:To determine the efficacy of lansoprazole control of acid and pepsin secretion over the long term in Zollinger–Ellison syndrome and non‐Zollinger–Ellison syndrome hypersecretors.Methods:Sixty‐three hypersecretors (basal acid output > 15 mmol/h), 46 Zollinger–Ellison syndrome and 17 non‐Zollinger–Ellison syndrome, with a total history of 15.4 and 19.2 years, respectively, were entered into a long‐term prospective study using lansoprazole. Sixty‐one were studied every 3 months for 1 year and then every 3–6 months up to 10 years during lansoprazole treatment with endoscopy, serum gastrin and gastric analysis, measuring both basal and stimulated pH and acid and pepsin secretion. Doses were individually optimized and adjusted to keep the basal acid output at < 5 mmol/h in intact patients and < 1 mmol/h in antrectomized Zollinger–Ellison syndrome patients.Results:The dose of lansoprazole could not be predicted a priori from pre‐treatment acid or pepsin output, serum gastrin, prior omeprazole dose or diagnosis or prior complications. The median dose was ∼ 80 mg/day, with a wide range from 15 mg every other day to 360 mg/day, and generally stabilized by 12 months. However, as doses were adjusted over time for indications, almost half the patients required higher doses. With adjustments, the basal acid output was maintained in the target range in > 90% of intact patients and in 80% of antrectomized patients. Gastric juice pH increased from ∼ 1.2 before therapy to > 3.4 during therapy. Serum gastrin in Zollinger–Ellison syndrome patients, after excluding five outliers, did not change over the course of therapy, but doubled in non‐Zollinger–Ellison syndrome patients. There were no adverse events due to lansoprazole, and routine laboratory studies remained normal.Conclusions:The dose of lansoprazole for hypersecretors cannot be predicted, and thus needs to be optimized empirically on an individual basis. With continued periodic adjustments, almost half the patients required increased doses, while safe dose reduction was possible in only one‐quarter. When individually optimized, lansoprazole proved to be safe and effective in the control of secretion for the treatment of both Zollinger–Ellison syndrome and non‐Zollinger–Ellison syndrome hypersecretors for up to 10 years.
Systematic review: the use of somatostatin or octreotide in refractory diarrhoea
Authors: Szilagyi A. , Shrier I. 
Published: March 2003

Background:Somatostatin and octreotide have multiple effects which make them ideal for treating diarrhoea of different aetiologies. Their use in a variety of conditions with refractory diarrhoea, however, is based on a limited number of studies.Aim:We undertook a systematic review of the available English literature to maximize an evidence‐based approach to the treatment of refractory diarrhoea. We tested the hypothesis that efficacy is independent of aetiology.Methods and resultsA Medline and individual article search from 1965 to 2000 was undertaken on the use of somatostatin and octreotide in diarrrhoea. All reports containing at least five subjects were included. The percentage response in case series and randomized controlled trials was compared, and a meta‐analysis of randomized controlled trials where patient level data were provided was carried out. There were 30 publications found (18 case series, 12 randomized controlled trials). The response percentage was 73% overall in case series and 64% in randomized controlled trials (not significant). A meta‐analysis of nine randomized controlled trials revealed significant heterogeneity despite an overall relative risk of 0.5 (95% confidence interval, 0.27–0.91). Subgroup analysis of the largest aetiological groups showed that acquired immunodeficiency syndrome studies were homogeneous, but somatostatin and octreotide were less effective. Post‐chemotherapy studies remained heterogeneous and somatostatin and octreotide were highly effective.ConclusionsWhile this review strengthens the consensus guidelines on the use of somatostatin and octreotide for refractory diarrhoea, evidence‐based support requires additional studies.
Clinical and endoscopic characteristics of non‐Helicobacter pylori, non‐NSAID duodenal ulcers: a long‐term prospective study
Authors: Xia H. H.‐X. , Wong B. C. Y. , Wong K. W. , Wong S. Y. , Wong W. M. , Lai K. C. , Hu W. H. C. , Chan C. K. , Lam S. K. 
Published: March 2003

Background:The proportion of duodenal ulcers not associated with Helicobacter pylori infection or the use of non‐steroidal anti‐inflammatory drugs (NSAIDs) is increasing.Aim:To identify the clinical and endoscopic characteristics of non‐H. pylori, non‐NSAID duodenal ulcers.Methods:Clinical and endoscopic data and H. pylori status were prospectively collected from consecutive patients who underwent upper endoscopy from 1997 to 1999. Patients with duodenal ulcers were identified, and those with non‐H. pylori, non‐NSAID duodenal ulcers were analysed further.Results:A total of 11 717 upper endoscopies were performed in 8344 patients. Of these, 1153 (14%) had duodenal ulcers. Of 599 patients with active ulcers and known H. pylori status, 104 (17%) had ulcers not associated with H. pylori or the use of NSAIDs, 393 (66%) had ulcers associated with H. pylori alone, 51 (8.5%) had ulcers associated with the use of NSAIDs alone and 51 (8.5%) had ulcers associated with both. Multivariate logistic regression analysis revealed that the presence of concomitant diseases (odds ratio=15.0; 95% confidence interval, 8.64–25.9; P < 0.001) and the absence of epigastric pain/discomfort (odds ratio=0.52; 95% confidence interval, 0.29–0.91; P=0.022) were independent predictors for non‐H. pylori, non‐NSAID duodenal ulcers.Conclusions:Non‐H. pylori, non‐NSAID duodenal ulcers exhibit certain distinct clinical and endoscopic characteristics. The presence of concomitant diseases is an important predictive factor.
Enteric‐release glyceryl trinitrate in active Crohn’s disease: a randomized, double‐blind, placebo‐controlled trial
Authors: Hawkes N. D. , Richardson C. , Ch'Ng C. L. , Green J. T. , Evans B. K. , Williams J. , Rhodes P. , Rhodes J. , Swift G. L. , Thomas G. A. O. , Hawthorne A. B. , Kingham J. G. C. , Mayberry J. F. 
Published: March 2003

Background:Mucosal ischaemia may contribute to the pathogenesis of Crohn’s disease. Microvascular abnormalities have been found in colonic resection specimens, and mucosal levels of constitutive nitric oxide synthase are reduced.Aim:To assess the efficacy of a novel, enteric‐release formulation of the nitric oxide donor, glyceryl trinitrate, aimed at increasing the mucosal circulation and relaxing smooth muscle in the affected bowel.Methods:The trial was randomized, double‐blind and placebo‐controlled. Baseline disease activity was assessed by a structured symptom diary, with blood tests and a quality of life assessment. Patients with a Crohn’s disease activity index of ≥ 150 and < 450 were randomized to receive 12 weeks of either glyceryl trinitrate (initially 6 mg twice daily, increasing to 9 mg twice daily after 6 weeks) or an identical placebo. Assessments were repeated at 6 and 12 weeks.Results:Seventy patients (22 male) entered the study; 34 were given glyceryl trinitrate and 36 placebo. At 12 weeks, there were no differences between the treatment groups in terms of Crohn’s disease activity index, pain, stool frequency, inflammatory markers or quality of life scores.Conclusions:Enteric‐release glyceryl trinitrate did not benefit patients with mild to moderately active Crohn’s disease. Whilst ischaemia may contribute to the pathogenesis of Crohn’s disease, our results fail to provide supportive evidence for this hypothesis.
Interaction between azathioprine and aminosalicylates: an in vivo study in patients with Crohn’s disease
Authors: Dewit O. , Vanheuverzwyn R. , Desager J. P. , Horsmans Y. 
Published: March 2003

Background:The inhibition of thiopurine methyltransferase activity, one of the enzymes responsible for azathioprine metabolism, by aminosalicylates has been described in an in vitro study. This could result in a higher risk of bone marrow depression when using the two drugs together.Aim:To investigate the in vivo interaction between azathioprine and aminosalicylates in quiescent Crohn’s disease by measuring 6‐thioguanine nucleotide levels, thiopurine methyltransferase activity and the plasma levels of the acetylated metabolite of 5‐aminosalicylic acid.Methods:Sixteen patients taking a stable dose of azathioprine, plus sulfasalazine or mesalazine, were enrolled and completed the study. They were not taking any drugs interfering with azathioprine metabolism. Four visits every 4 weeks were held over a 3‐month period. Aminosalicylate administration was withdrawn after the second visit. At each visit, the blood cell count, inflammatory parameters, levels of 6‐thioguanine nucleotide and the acetylated metabolite of 5‐aminosalicylic acid and thiopurine methyltransferase activity were determined.Results:After aminosalicylate withdrawal, mean 6‐thioguanine nucleotide levels decreased significantly from 148 pmol (57–357 pmol) to 132 pmol (56–247 pmol) per 8 × 108 red blood cells (P=0.027), without significant changes in thiopurine methyltransferase activity or biological parameters.Conclusions:This in vivo study favours the existence of an interaction between azathioprine and aminosalicylates through a mechanism which remains unclear. This drug–drug interaction should be taken into account when using azathioprine and aminosalicylates simultaneously.