bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of propranolol and depot lanreotide SR on postprandial and circadian portal haemodynamics in cirrhosis
Authors: Schiedermaier P. , Koch L. , Stoffel‐Wagner B. , Layer G. , Sauerbruch T. 
Published: December 2004

SummaryBackground : Long‐acting somatostatin analogues have been suggested as an alternative to propranolol for the prevention of variceal rebleeding.Aim : To compare the effectiveness of lanreotide SR, a new depot formulation injected once‐weekly, and propranolol in reducing circadian portal blood flow (PVF) and meal‐stimulated hepatic venous pressure gradient (HVPG) in patients with liver cirrhosis.Methods : Patients were randomized to receive either lanreotide SR intramuscularly (30 mg once weekly, n = 12) or propranolol (n = 12) orally. Hemodynamic measurements were performed on day 0 and on day 21 after a 3‐week period of drug administration, while patients received three standard oral liquid test meals. On each study day 27 PVF measurements were performed over 24 h and eight measurements of HVPG during the first postprandial period.Results : Propranolol was more effective than lanreotide SR in reducing baseline HVPG (−21.9 vs. −13.6%, P = 0.04) and meal‐stimulated HVPG (−16.6 vs. −3.8%, P = 0.04). Propranolol reduced circadian PVF significantly by 9.3% (P = 0.03) but not lanreotide SR.Conclusions : Long‐term treatment with propranolol reduced baseline and postprandial HVPG and circadian PVF, while lanreotide SR did not. The results of our study do not encourage clinical testing of lanreotide SR 30 mg for the prevention of variceal haemorrhage.
Current patterns of irritable bowel syndrome in Taiwan: the Rome II questionnaire on a Chinese population
Authors: Lu C.‐L. , Chen C.‐Y. , Lang H.‐C. , Luo J.‐C. , Wang S.‐S. , Chang F.‐Y. , Lee S.‐D. 
Published: December 2004

SummaryBackground : Irritable bowel syndrome is a common condition seen in Western countries. In Asia, however, it is less known and even less studied.Aim : To determine the prevalence and social impact of irritable bowel syndrome as well as the health‐seeking behaviour of irritable bowel syndrome patients in TaiwanMethods : Using the modified Rome II questionnaire, a survey was carried out in a population receiving physical check‐up (n = 2865).Results : The prevalence of irritable bowel syndrome in Taiwan was 22.1% and 17.5% (κ = 0.73) according to the Rome II and I criteria, respectively. No gender difference was found between subjects with and without irritable bowel syndrome symptoms. Irritable bowel syndrome subjects were likely to undertake an excessive number of physician‐visits (P < 0.01). Such subjects were often absent from work/school, with more days of absenteeism than irritable bowel syndrome‐free subjects (P < 0.01). They also suffered obvious sleep disturbance (P < 0.01). Nearly half of the irritable bowel syndrome subjects were ‘consulters’, and they were more likely to have frequent physician‐visits, suffer from work/school absenteeism, and endure sleep disturbance and bowel symptoms than irritable bowel syndrome nonconsulters (P < 0.05).Conclusions : Irritable bowel syndrome is common in a Chinese population of Taiwan. Similar to irritable bowel syndrome in the West, it also involves significant social and medical burdens. However, in the irritable bowel syndrome subjects of Taiwan there is no gender difference, and more irritable bowel syndrome subjects will seek physician consultations, which may be due to Taiwan's easily accessible and affordable heath care facilities.
Gastric acid‐suppressive therapy and community‐acquired respiratory infections
Authors: Laheij R. J. F. , Van Ijzendoorn M. C. , Janssen M. J. R. , Jansen J. B. M. J. 
Published: December 2004

SummaryBackground : Bacteria and viruses have been detected in the stomach of patients during acid‐suppressive therapy.Aim : To investigate whether subjects using acid‐suppressive drugs more often develop community‐acquired respiratory infections when compared to those who do not use acid‐suppressive drugs.Methods : 700 study subjects were recruited during a single week in December 2002. Information on the prevalence of clinical manifestations of infections and complications in the preceding month was assessed by questionnaire. Furthermore, subjects were asked to report antibiotic therapy and physician visits related to possible infection.Results : Questionnaires were returned by 405 subjects (58%). Consumption of acid‐suppressive drugs was reported by 91 individuals, of whom 79 used proton‐pump inhibitors (20%) and 12 H2‐receptor antagonists (3%). Overall, 101 (25%) responders reported clinical manifestations of respiratory infection in the preceding month. Subjects using acid‐suppressive drugs were 2.34 times [95% confidence interval (CI) 1.4–4.1] more likely to have clinical manifestations of infection than individuals not using acid‐suppressive drugs. Subjects using acid‐suppressive drugs visited a physician 3.72 times more often (95% CI 2.1–6.8) for an infection and received antibiotic therapy 4.19 times more often (95% CI 2.2–8.1) in comparison to individuals not using acid‐suppressive drugs.Conclusions : Subjects using acid‐suppressive drugs more often reported community‐acquired respiratory infections in comparison to those who did not use acid‐suppressive drugs.
13C‐methacetin breath test for monitoring hepatic function in cirrhotic patients before and after liver transplantation
Authors: Petrolati A. , Festi D. , De Berardinis G. , Colaiocco‐Ferrante L. , Di Paolo D. , Tisone G. , Angelico M. 
Published: December 2004

SummaryBackground : In patients with chronic liver disease, the measurement of liver function is critical for monitoring disease progression, predicting the prognosis and choosing therapeutic strategies. The 13C‐methacetin breath test is a simple, non‐invasive diagnostic tool based on an inexpensive, non‐toxic substance, which allows the accurate measurement of liver functional reserve.Aim : To investigate the 13C‐methacetin breath test as a tool to monitor hepatic function in liver transplant candidates and recipients.Methods : Twenty‐eight cirrhotic patients listed for orthotopic liver transplantation and 10 healthy controls were studied. The 13C‐methacetin breath test (75 mg per os) was performed at baseline and at 12‐week intervals. Intra‐operative measurements were obtained during the liver transplantation procedure in nine patients. Results were expressed as the 13C‐methacetin cumulative oxidation percentage 45 min after substrate ingestion.Results : The mean 13C‐methacetin cumulative oxidation at 45 min was 16.4 ± 3.5% in healthy controls and 5.4 ± 4.2% in cirrhotic patients at the time of listing. In 11 patients who underwent successful liver transplantation, mean oxidation increased from 3.3 ± 1.6% before transplantation to 17.0 ± 5.2% at 6 months of follow‐up. Variations in methacetine oxidation were closely related to the recovery of liver function. The mean intra‐operative 13C‐methacetin cumulative oxidation increased from 0.1% during the anhepatic phase to 3.7 ± 2.0% 2 h after reperfusion.Conclusions : The 13C‐methacetin breath test is a simple and potentially useful tool for monitoring hepatic function in cirrhotic patients listed for liver transplantation, and during the intra‐operative and post‐operative phases.
Randomized study of different ‘second‐line’ therapies for Helicobacter pylori infection after failure of the standard ‘Maastricht triple therapy’
Authors: Perri F. , Festa V. , Merla A. , Barberani F. , Pilotto A. , Andriulli A. 
Published: December 2004

SummaryBackground : Triple therapy with proton pump inhibitor, clarithromycin and amoxicillin and, in the event of eradication failure, quadruple therapy with proton pump inhibitor, bismuth, tetracycline and metronidazole have been proposed in Maastricht as the optimal sequential treatment of Helicobacter pylori infection.Aim : To compare two second‐line regimens with quadruple therapy.Methods : One hundred and eighty patients with a previous failed course of standard therapy were randomly given one of the following 7‐day treatments: ranitidine bismuth citrate 400 mg b.d. plus amoxicillin 1 g b.d. and tinidazole 500 mg b.d. (RBCAT), pantoprazole 40 mg b.d. plus amoxicillin 1 g b.d. and levofloxacin 500 mg/day (PAL) and pantoprazole 40 mg b.d., bismuth citrate 240 mg b.d., tetracycline 500 mg q.d.s. and metronidazole 500 mg b.d. (PBTM). The eradication rate was assessed by 13C‐urea breath test. Side‐effects and compliance were evaluated by a standardized questionnaire and by counting returned medication.Results : The RBCAT, PAL and PBTM groups achieved mean intention‐to‐treat eradication rates of 85%, 63% and 83%, respectively (P < 0.05 for PAL vs. either RBCAT or PBTM). Compliance was optimal in all patients, although side‐effects were more commonly observed in the PBTM group than in the other two patient groups (P < 0.0001).Conclusions : Both RBCAT and PBTM can be used as second‐line therapies. Conversely, PAL did not achieve satisfactory eradication rates.
Role of antibiotic sensitivity testing before first‐line Helicobacter pylori eradication treatments
Authors: Neri M. , Milano A. , Laterza F. , Di Bonaventura G. , Piccolomini R. , Caldarella M. P. , Balatsinou C. , Lapenna D. , Cuccurullo F. 
Published: December 2004

SummaryBackground : The resistance of Helicobacter pylori to antibiotics has been advocated as a major cause of treatment failure, and antimicrobial sensitivity testing has been proposed to improve efficacy; however, its role before first‐line therapy has not been investigated in detail.Aim : To assess whether antimicrobial sensitivity testing improves the eradication rate of first‐line anti‐Helicobacter treatments and to compare the effectiveness of ranitidine bismuth citrate and omeprazole in the presence of H. pylori resistance to antibiotics.Methods : Two hundred and forty‐two patients were assigned to either empirical or antimicrobial sensitivity testing‐based treatment; within each group, subjects were further randomized to receive ranitidine bismuth citrate, 400 mg b.d., tinidazole, 500 mg b.d., and clarithromycin, 500 mg b.d., or omeprazole, 20 mg b.d., clarithromycin, 500 mg b.d., and amoxicillin, 1 g b.d., for 1 week, with substitution of the resistant antibiotic in the antimicrobial sensitivity testing‐based treatment group.Results : Eradication rates were 67% [confidence interval (CI), 55–79%] in the empirical treatment group and 76% (CI, 65–87%) in the antimicrobial sensitivity testing‐based group (P = N.S.). The overall success rate was 60% (CI, 51–69%) with omeprazole and 82% (CI, 73–91%) with ranitidine bismuth citrate (P < 0.03); the latter overcame antibiotic resistance in 12 of 15 strains vs. zero of eight strains by omeprazole.Conclusions : Antimicrobial sensitivity testing before first‐line treatment does not improve the eradication rate, which is greater when ranitidine bismuth citrate is included in the treatment.
Lansoprazole reduces ulcer relapse after eradication of Helicobacter pylori in nonsteroidal anti‐inflammatory drug users – a randomized trial
Authors: Lai K. C. , Lam S. K. , Chu K. M. , Hui W. M. , Kwok K. F. , Wong B. C. Y. , Hu H. C. , Wong W. M. , Chan O. O. , Chan C. K. 
Published: December 2004

SummaryAim : To study whether prophylaxis with lansoprazole could prevent relapse of ulcers after eradication of Helicobacter pylori in patients with NSAID‐related peptic ulcers.Methods : Patients who presented with peptic ulcers and were found to be infected with H. pylori while receiving NSAIDs were recruited into the study. They received, twice daily, lansoprazole 30 mg, amoxicillin 1 g and clarithromycin 500 mg for 1 week, followed by lansoprazole 30 mg daily for 4 weeks. Patients with healed ulcers and H. pylori eradicated were given naproxen 750 mg daily, and randomly assigned to receive lansoprazole 30 mg daily or no treatment for 8 weeks. The primary endpoint was the cumulative recurrence of symptomatic and complicated ulcers.Results : At the end of the 8‐week treatment period, significantly fewer patients (1/22, 4.5%, 95% confidence interval [CI] 0–23) in the lansoprazole group compared with the group that received H. pylori eradication alone (9/21, 42.9%, 95% CI 22–66) developed recurrence of symptomatic and complicated ulcers (log rank test P = 0.0025).Conclusions : Lansoprazole significantly reduced the cumulative relapse of symptomatic and complicated ulcers in patients requiring NSAIDs after eradication of H. pylori.
Meta‐analysis: proton pump inhibitors vs. H2‐receptor antagonists — their efficacy with antibiotics in Helicobacter pylori eradication
Authors: Gisbert J. P. , Khorrami S. , Calvet X. , Gabriel R. , Carballo F. , Pajares J. M. 
Published: December 2004

SummaryBackground : It is unknown whether proton pump inhibitors are superior to H2‐receptor antagonists in Helicobacter pylori eradication regimens.Aim : To perform a meta‐analysis comparing the efficacy of both antisecretors when co‐prescribed with antibiotics.Methods : Randomized clinical trials comparing proton pump inhibitors vs. H2‐receptor antagonists with the same antibiotics were selected. Data sources included PubMed, the Cochrane Controlled Trials Register and abstracts from congresses up to January 2002. A meta‐analysis was performed by combining the odds ratios.Results : Twenty studies fulfilled the inclusion criteria. In the intention‐to‐treat analysis, the mean eradication rates with proton pump inhibitors and H2‐receptor antagonists plus antibiotics were 74% [95% confidence interval (CI), 71–76%] and 69% (95% CI, 66–71%), respectively. The odds ratio for this comparison was 1.31 (95% CI, 1.09–1.58). The number needed to treat with proton pump inhibitors to achieve eradication success, compared with H2‐receptor antagonists, was 25. When studies prescribing very high doses of H2‐receptor antagonists (two of the outliers) were excluded, the odds ratio (for proton pump inhibitors vs. H2‐receptor antagonists) increased to 1.37, the number needed to treat decreased to 20 and the heterogeneity between the studies decreased.Conclusions : Overall, proton pump inhibitors are more effective than H2‐receptor antagonists when prescribed at usual doses with antibiotics to eradicate H. pylori infection.
Different patterns of oesophageal acid exposure distinguish complicated reflux disease from either erosive reflux oesophagitis or non‐erosive reflux disease
Authors: Frazzoni M. , De Micheli E. , Savarino V. 
Published: December 2004

SummaryBackground : The reason why less than one‐half of patients with gastro‐oesophageal reflux disease develop complicated reflux disease (ulcerative oesophagitis, oesophageal strictures and Barrett's oesophagus) and erosive reflux oesophagitis is not fully understood. Supine nocturnal oesophageal acid reflux is considered to be critically involved in this phenomenon, but reliable data are lacking.Aim : To clarify whether high levels of supine nocturnal oesophageal acid exposure are associated with complicated reflux disease.Methods : Ambulatory 24‐h oesophageal pH monitoring was performed in 220 patients with gastro‐oesophageal reflux disease (56 with complicated reflux disease, 76 with erosive reflux oesophagitis and 88 with non‐erosive reflux disease). The total, supine nocturnal and upright diurnal percentage acid reflux times were calculated.Results : The total percentage acid reflux time was significantly greater in complicated reflux disease than in either erosive reflux oesophagitis (P = 0.024) or non‐erosive reflux disease (P = 0.000). These differences were entirely due to a greater supine nocturnal percentage acid reflux time (P = 0.038 and P = 0.000, respectively), whereas no difference was observed in the upright diurnal percentage acid reflux time.Conclusions : Complicated reflux disease is characterized by high levels of supine nocturnal percentage acid reflux time. Prospective studies would be appropriate to clarify whether the normalization of this parameter is relevant to the effective management of this subset of patients with gastro‐oesophageal reflux disease.
Symptoms of gastro‐oesophageal reflux: prevalence, severity, duration and associated factors in a Spanish population
Authors: Diaz‐Rubio M. , Moreno‐Elola‐Olaso C. , Rey E. , Locke G. R. , Rodriguez‐Artalejo F. 
Published: December 2004

SummaryAim : To measure the prevalence of gastro‐oesophageal reflux symptoms and to identify associated factors in a representative sample of the Spanish population.Methods : A telephone survey of 2500 subjects was performed using a validated questionnaire. The association of gastro‐oesophageal reflux symptoms (defined as the presence of heartburn or acid regurgitation) and their clinical characteristics with potential risk factors was summarized using the odds ratios (OR) obtained by multiple logistic regression.Results : The response rate was 71.2%. The annual prevalence of gastro‐oesophageal reflux symptoms was 31.6%[95% confidence interval (CI), 29.8–33.4] and the weekly prevalence was 9.8% (95% CI, 8.6–10.9). Gastro‐oesophageal reflux symptoms were associated with excess weight (OR, 1.53; 95% CI, 1.23–1.92), obesity (OR, 1.74; 95% CI, 1.30–2.32), the psychosomatic symptom score (OR, 2.98; 95% CI, 2.41–3.67) and the presence of gastro‐oesophageal reflux symptoms in a direct family member (OR, 1.61; 95% CI, 1.17–2.23). Gastro‐oesophageal reflux symptoms of ≥ 10 years' duration were more frequent in obese subjects (OR, 1.92; 95% CI, 1.14–3.22) and those with a direct family member with gastro‐oesophageal reflux symptoms (OR, 2.42; 95% CI, 1.44–4.06). Factors associated with gastro‐oesophageal reflux symptoms of ≤ 1 year duration were a spouse with gastro‐oesophageal reflux symptoms (OR, 2.33; 95% CI, 1.39–3.9) and the consumption of 1–5 aspirins/week (OR, 1.70; 95% CI, 1.01–2.86).Conclusions : The prevalence of frequent gastro‐oesophageal reflux symptoms in Spain is lower than that observed in other Western populations. The psychosomatic symptom score is the factor most strongly associated with gastro‐oesophageal reflux symptoms. Long‐term gastro‐oesophageal reflux symptoms are associated with certain genetic factors (obesity, family history of gastro‐oesophageal reflux symptoms), whereas short‐term gastro‐oesophageal reflux symptoms are associated with factors of probable environmental nature.
Quality of life in relation to symptoms in patients with gastro‐oesophageal reflux disease — an analysis based on the ProGERD initiative
Authors: Kulig M. , Leodolter A. , Vieth M. , Schulte E. , Jaspersen D. , Labenz J. , Lind T. , Meyer‐Sabellek W. , Malfertheiner P. , Stolte M. , Willich S. N. 
Published: December 2004

SummaryAims : To determine the impact of gastro‐oesophageal reflux disease (GERD) on the quality of life, to assess changes in the quality of life during treatment with esomeprazole and to define factors that can predict these changes.Methods : Patients with GERD (n = 6215) were included in a prospective cohort study (ProGERD). All patients underwent endoscopy and received esomeprazole. At baseline and after 2 weeks of treatment, symptoms and quality of life were assessed. Factors that influenced changes in the quality of life were determined by multiple regression analyses.Results : At baseline, the quality of life in GERD patients was lower than that in the general population, and was similar to that in patients after acute coronary events. No differences in symptoms or quality of life were observed between the subgroups of patients with non‐erosive GERD, erosive GERD and Barrett's oesophagus. After treatment with esomeprazole, the symptoms and quality of life were improved in all subscales within 2 weeks (P < 0.001). The mean score of the disease‐specific quality of life instrument (Quality of Life in Reflux and Dyspepsia Patients) increased from 4.6 to 6.2 points, representing a highly relevant clinical improvement. The generic quality of life (SF‐36) reached levels similar to those in the general population, but, again, no difference was found between the three different subgroups of GERD patients. The main factors associated with an improvement in the quality of life after treatment were symptom relief, severe erosive reflux disease, absence of extra‐oesophageal disorders, avoidance of non‐steroidal anti‐inflammatory drug intake and positive Helicobacter pylori status.Conclusions : GERD causes a significant impairment in the quality of life that can be attenuated or normalized within a time period as short as 2 weeks by treatment with esomeprazole. These findings were similar across the whole GERD patient spectrum.
Assessment of oesophageal motor function in patients with dysphagia or chest pain — the Clinical Outcomes Research Initiative experience
Authors: Dekel R. , Pearson T. , Wendel C. , De Garmo P. , Fennerty M. B. , Fass R. 
Published: December 2004

SummaryBackground : Available prospectively acquired data on the distribution of oesophageal motor abnormalities in patients being evaluated for non‐cardiac chest pain and/or dysphagia are relatively scarce.Aim : To evaluate the distribution of oesophageal motor abnormalities in patients with dysphagia, non‐cardiac chest pain or both using the national Clinical Outcomes Research Initiative (CORI) database.Methods : The CORI oesophageal motility database originates from 19 community, university and VA medical centres. Data were collected using a computerized motility report‐generating program, combined with the CORI module. Data from each site were encrypted and sent to the CORI National Repository for analysis. The database includes the assessment of the lower and upper oesophageal sphincter function and the motor activity of the oesophageal body.Results : Five hundred and eighty‐seven consecutive patients who underwent motility studies between 1998 and 2001 were included in the CORI database and analysed for this report. Four hundred and three patients (69%) had dysphagia as their primary indicator for the examination, 140 patients (24%) had non‐cardiac chest pain and 44 patients (7%) had both dysphagia and non‐cardiac chest pain. In all three groups, a normal motility study was the most frequent finding (dysphagia, 53%; chest pain, 70%; both, 55%). The most common motility abnormality in the group with non‐cardiac chest pain was a hypotensive lower oesophageal sphincter (61%). Nutcracker oesophagus and non‐specific oesophageal motility disorders were each diagnosed in only 10% of patients with non‐cardiac chest pain. In patients with dysphagia, ineffective peristalsis was the most common oesophageal dysmotility (27%), followed by achalasia and non‐specific oesophageal motility disorders (18% and 14%, respectively). Achalasia and non‐specific oesophageal motility disorders were the most common oesophageal motility abnormalities in patients with both chest pain and dysphagia (35% and 25%, respectively).Conclusions : The most common oesophageal motility abnormality in patients with non‐cardiac chest pain is a hypotensive lower oesophageal sphincter; nutcracker oesophagus and non‐specific oesophageal motility disorders are relatively uncommon; the most common oesophageal motility abnormality in patients with dysphagia is ineffective peristalsis and, for those with both dysphagia and non‐cardiac chest pain, it is achalasia.