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  • 1
    Electronic Resource
    Electronic Resource
    Biliary secretion of moxifloxacin in obstructive cholangitis and the non-obstructed biliary tract (2005)
    Oxford, UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 22 (2005), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background : Biliary secretion of antibiotic agents into the bile is considerably compromised by biliary obstruction, a precondition of bacterial cholangitis. Moxifloxacin may be advantageous according to secretion and antimicrobial spectrum.Aim : To establish the secretion of moxifloxacin into obstructed and non-obstructed bile.Methods : Biliary excretion of moxifloxacin was determined in plasma and bile of 10 patients with biliary obstruction and cholangitis and 10 patients without biliary obstruction 30 min after administration of 400 mg of moxifloxacin intravenously.Results : The plasma concentration of moxifloxacin was similar in both groups (4.45 ± 1.58 μg/mL; 4.33 ± 1.23 μg/mL). The concentration of moxifloxacin in the bile was significantly lower in patients with biliary obstruction than without (4.63 ± 3.94 μg/mL; range 0.71–14.40; vs. 16.90 ± 13.77 μg/mL; range 1.79–42.50; P = 0.043). Although significantly different, the penetration index was extensively high in those without biliary obstruction (4.41 ± 4.40; range 0.35–14.45) but still sufficient in those patients with obstructive cholangitis (1.02 ± 0.74; range 0.29–2.83; P = 0.035).Conclusion : These findings are suggestive of an active secretion mechanism for moxifloxacin into the obstructed bile, producing a biliary concentration sufficiently above the minimal inhibitory concentrations for most of the expected bacteria.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2036.2005.02567.x
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  • 2
    Electronic Resource
    Electronic Resource
    Implementation of a computer-assisted monitoring system for the detection of adverse drug reactions in gastroenterology (2004)
    Oxford, UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 19 (2004), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Aim : To investigate the effectiveness of a computer monitoring system that detects adverse drug reactions (ADRs) by laboratory signals in gastroenterology.Methods : A prospective, 6-month, pharmacoepidemiological survey was carried out on a gastroenterological ward at the University Hospital Erlangen-Nuremberg. Two methods were used to identify ADRs. (i) All charts were reviewed daily by physicians and clinical pharmacists. (ii) A computer monitoring system generated a daily list of automatic laboratory signals and alerts of ADRs, including patient data and dates of events.Results : One hundred and nine ADRs were detected in 474 admissions (377 patients). The computer monitoring system generated 4454 automatic laboratory signals from 39 819 laboratory parameters tested, and issued 2328 alerts, 914 (39%) of which were associated with ADRs; 574 (25%) were associated with ADR-positive admissions. Of all the alerts generated, signals of hepatotoxicity (1255), followed by coagulation disorders (407) and haematological toxicity (207), were prevalent. Correspondingly, the prevailing ADRs were concerned with the metabolic and hepato-gastrointestinal system (61). The sensitivity was 91%: 69 of 76 ADR-positive patients were indicated by an alert. The specificity of alerts was increased from 23% to 76% after implementation of an automatic laboratory signal trend monitoring algorithm.Conclusion : This study shows that a computer monitoring system is a useful tool for the systematic and automated detection of ADRs in gastroenterological patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2036.2004.01854.x
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  • 3
    Electronic Resource
    Electronic Resource
    Expression of hepatocyte growth factor, transforming growth factor alpha, apoptosis related proteins Bax and Bcl-2, and gastrin in human gastric cancer (2001)
    Oxford UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 15 (2001), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Gastric cancer is one of the most frequent neoplasms and a leading cause of the death world-wide. In recent years, epidemiological and animal studies demonstrated a link between gastric cancer and chronic infection with H. pylori. The exact mechanism responsible for the development of gastric cancer in H. pylori-infected patients still remains unclear. There is evidence that the up-regulation of certain growth factors could play an important role in the promotion of the gastric carcinogenesis.〈section xml:id="abs1-2"〉〈title type="main"〉Aims:The present study was designed to determine the gene expression of major known growth factors such as transforming growth factor alpha (TGFα), hepatocyte growth factor (HGF) and gastrin in the gastric cancer tissue, the surrounding mucosa and, for comparison, in the normal gastric mucosa. Furthermore, the luminal and plasma levels of gastrin in patients with gastric cancer were determined. In addition, the gene and protein expressions of apoptosis-related proteins such as Bax and Bcl-2 were investigated by reverse transcription-polymerase chain reaction and Western blot. Twenty-five gastric cancer patients and 40 age- and gender-matched control subjects hospitalized with non-ulcer dyspepsia were included into this study.〈section xml:id="abs1-3"〉〈title type="main"〉Results:An overall H. pylori-seropositivity among gastric cancer patients was about 72% and was significantly higher than in the controls (56%). The prevalence of CagA-positive strains was also significantly higher among gastric cancer patients than in controls (56% vs. 32%). The gene expression of HGF and TGFα was detected more frequently in gastric cancer tissue samples than in normal gastric mucosa (52% vs. 12% for HGF and 48% vs. 24% for TGFα). The extent of protein expression in Western blotting analysis for HGF and TGFα correlated with the mRNA expression of these factors. Gene expression of gastrin was detected in the antrum of all tested patients and in the majority (84%) of gastric cancer patients. The median plasma and luminal concentrations of gastrin in gastric cancer patients were significantly higher than in controls. The gene expression of bcl-2 was detected in all (100%) and that of proapoptotic bax only in 56% of gastric cancer samples. In comparison to the surrounding non-tumorous tisssue, the gene expression of bax was significantly down-regulated and the gene expression of bcl-2 was up-regulated in gastric cancer tissue. At the protein level, Bax was not detectable and Bcl-2 was seen in 80% of gastric cancer samples.〈section xml:id="abs1-4"〉〈title type="main"〉Conclusions:It is concluded that the patients infected with H. pylori, especially with CagA-positive strains, are at a higher risk of developing a gastric cancer. An increased production and release of gastrin, as well as an over-expression of growth factors such as HGF and TGFα, might contribute to the gastric carcinogenesis. In addition, a dysregulation of the Bax/Bcl-2 system with significant up-regulation of Bcl-2 is observed in gastric cancer.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2036.2001.01003.x
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  • 4
    Electronic Resource
    Electronic Resource
    Adverse drug reactions in patients with gastroenterological diseases: does age increase the risk? (2001)
    Oxford UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 15 (2001), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: It has been claimed that the risk of adverse drug reactions increases with age. However, only limited data exist for disease-group specific risks and none for patients with liver and gastrointestinal diseases.〈section xml:id="abs1-2"〉〈title type="main"〉Aims:To determine the incidence and characteristics of adverse drug reactions and the physicians’ awareness of adverse drug reactions.〈section xml:id="abs1-3"〉〈title type="main"〉Methods:During a 7-month period, a prospective survey of 532 male patients (158 aged 65 years or older; 30%) was conducted on a hepatogastroenterological ward of a tertiary-care university hospital, using intensive bedside and computer-assisted drug surveillance methods.〈section xml:id="abs1-4"〉〈title type="main"〉Results:No difference was found in the overall rate of adverse drug reactions between older and younger patients (25.9% vs. 24.2%) during 6213 treatment days. However, a significantly higher risk for developing adverse drug reactions could be shown for the elderly with biliary tract diseases (P 〈 0.01). Independently of age, patients suffering from gastric ulcers, acute episodes of pancreatitis, cholangitis or inflammatory bowel diseases were at high risk of adverse drug reactions. Adverse drug reaction-associated mortality was encountered in four elderly and none of the younger patients. Secondary pharmacological effects and drug toxicity were the main types of adverse drug reactions for both age groups. Although 75.3% of the adverse drug reactions were predictable, only 37.5% of all adverse drug reactions were recognized by the staff physicians.〈section xml:id="abs1-5"〉〈title type="main"〉Conclusion:In hepatogastroenterological patients, advancing age was not associated with an overall increased risk of adverse drug reactions except for patients with biliary tract diseases. In the elderly, adverse drug reactions were more severe and carried higher mortality. Guidelines and educational programs should be developed to increase the awareness of adverse drug reactions and their prevention, especially in high risk patients and, thus, to improve patient outcomes.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2036.2001.00922.x
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  • 5
    Electronic Resource
    Electronic Resource
    Antigastric autoantibodies in Helicobacter pylori gastritis: prevalence, in-situ binding sites and clues for clinical relevance (1996)
    Springer
    Virchows Archiv 427 (1996), S. 483-486 
    Details
    ISSN: 1432-2307
    Keywords: Helicobacter pylori ; Gastritis ; Host response ; Autoimmunity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Colonization of human gastric mucosa with Helicobacter pylori leads to chronic active gastritis and induces the occurrence of an acquired mucosa-associated lymphoid tissue (MALT) in the stomach. This remodelling of the gastric mucosa together with chronic antigen persistence may induce autoimmune reactions. The aim of this study was to investigate humoral autoimmune reactions to human gastric mucosa in H. pylori gastritis and their clinical relevance. Sera from patients with dyspeptic symptoms were tested for presence of IgG immunoglobulins against H. pylori. Gastric infection with H. pylori and alterations of gastric mucosa were demonstrated by histological examination of gastric biopsy specimens. All sera were tested for reactivity against human gastric mucosa by immunohistochemistry. Two different in-situ binding sites of antigastric autoantibodies were observed. Binding to canalicular structures within parietal cells was significantly correlated with antibodies to H. pylori, elevated basal gastrin levels and atrophy of gastric corpus glands. Our data indicate that autoimmune reactions to antigens in the human gastric mucosa occur in H. pylori gastritis and that they may play a role in the pathogenesis of the disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00199508
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  • 6
    Electronic Resource
    Electronic Resource
    Non-responsiveness to hepatitis-B vaccination: Revaccination and immunogenetic typing (1988)
    Springer
    Journal of molecular medicine 66 (1988), S. 670-674 
    Details
    ISSN: 1432-1440
    Keywords: Genetics ; Hepatitis-B virus ; Immunogenetics ; Vaccination
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The variation in immune responses to standard inoculation of the hepatitis-B virus vaccine suggest that host factors influence response in ways that are not presently understood. We studied 25 low/nonresponding health care workers (anti-HBs titer 〈50 IU/l) after the third inoculation of an experimental hepatitis-B vaccine to determine their immune status (through lymphocyte phenotypes) and HLA type. After application of a fourth inoculation, the seroconverting subjects showed only low anti-HBs levels; three male subjects remained anti-HBs negative. Twelve months after the fourth inoculation only 9 of 25 subjects (36%) maintained anti-HBs titer 〉10 IU/l. Almost all subjects had normal B-cell and CD-4 and CD-8 counts and ratios. Relative to other European populations HLA-A-10 (P〈0.05), B-12 (P〈0.025), CW-5 (P〈0.05), DR-3 (P〈0.025), and DR-5 (P〈0.025) were increased, whereas DR-2 (P〈0.05) was decreased. However, after correction of theP-values for the number of HLA antigens determined, these differences were no longer significant. Furthermore, these HLA types were not the same as those reported in other studies (except for DR-3). We suggest that larger sample sizes or even not yet available immunogenetic markers will be required to prove an “immunogenetic background” in low/nonresponders, if it exists.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01726924
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  • 7
    Electronic Resource
    Electronic Resource
    Risk of invasive carcinoma in colorectal adenomas assessed by size and site (1997)
    Springer
    International journal of colorectal disease 12 (1997), S. 267-271 
    Details
    ISSN: 1432-1262
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé. Problématique: Le risque de développer un carcinoma invasif en cas d'adénome colorectal est influencé par nombre de caractéristiques à la fois des patients et des adénomes dans le collectif d'échantillons analysés. Patients et méthodes: Entre 1978 et 1993, plus de 20,000 polypes ont été documentés prospectivement dans le registre des polypes colorectaux de Erlangen et analysés au moyen d'une analyse statistique de régression logique. Résultats: La taille des adénomes s'est révélée être le facteur le plus important en cas d'adénome de plus de 15 mm en comparaison avec des lésions plus petites. Cinq mille cent trente sept adénomes de moins de 5 mm sont porteurs d'un carcinome invasif. Les adénomes du côlon droit présentent un risque inférieur de malignité que ceux du côlon gauche ou du rectum mais le risque de dégénérescence augmente avec la taille de l'adénome. Dans le cas d'adénomes de moins de 36 mm de diamètre, le risque de carcinomes invasifs est observé plus fréquemment s'ils siègent au niveau du rectum ou du côlon gauche alors que des adénomes de plus de 36 mm sont plus fréquemment porteurs de carcinomes s'ils sont localisés dans le côlon droit ou le côlon gauche plutôt que le rectum. En conclusion: Une analyse multi-variée de 11,380 adénomes détectés à une première pancolonoscopie montre que les facteurs de siège et de taille qui peuvent tous deux être déterminés par la seule colonoscopie sont à même de prédire le risque de malignité de manière adéquate, tant sur le plan statistique que sur le plan clinique.
    Notes: Abstract . Background: The risk of invasive carcinoma developing in colorectal adenomas is influenced by a number of characteristics of both patients and adenomas, and the composition of the sample analysed. Patients and methods: Between 1978 and 1993 more than 20 000 polyps were prospectively documented at the Erlangen Registry of Colorectal Polyps, and analysed statistically by logistic regression. Results: The size of the adenomas proved to be the most important factor for adenomas equal to or larger than 15 mm as compared with smaller lesions. In 5137 diminutive adenomas (≤5 mm) invasive carcinoma was never found. Adenomas in the right-sided colon had a lower risk than those in the left colon or rectum, but with increasing adenoma size, the malignancy rate showed a right-sided shift. In adenomas of up to 36 mm in diameter, invasive carcinoma was found more often when they were located in the rectum or left colon while adenomas larger than 36 mm were more likely to harbour invasive carcinoma when located in the right or left colon rather than in the rectum. Conclusions: A multivariate analysis of 11380 adenomas detected at the first total colonoscopy showed that the factors size and site, both of which can be assessed by endoscopic inspection alone, were found to enable a statistically and clinically adequate assessment of the malignancy risk.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003840050103
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  • 8
    Electronic Resource
    Electronic Resource
    Evidence for mast cell activation in collagenous colitis (1998)
    Springer
    Inflammation research 47 (1998), S. 64-65 
    Details
    ISSN: 1420-908X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s000110050276
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  • 9
    Electronic Resource
    Electronic Resource
    Methylhistamine in Crohn's disease (CD): Increased production and elevated urine excretion correlates with disease activity (2000)
    Springer
    Inflammation research 49 (2000), S. 35-36 
    Details
    ISSN: 1420-908X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00000171
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  • 10
    Electronic Resource
    Electronic Resource
    German experimental hepatitis B vaccine — Influence of variation of dosage schedule, sex and age differences on immunogenicity in health care workers (1986)
    Springer
    Journal of molecular medicine 64 (1986), S. 688-694 
    Details
    ISSN: 1432-1440
    Keywords: Hepatitis B ; Vaccination ; Immunogenicity ; Dosage ; Age ; Sex
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Of the medical staff of our hospital 217 members at high risk for hepatitis B were immunized with an experimental hepatitis B vaccine and anti-HBs titers used to study the influence of two dosage schedules, age, and sex on immunogenicity. Participants were 34 years of age (mean; range, 20–61); they were divided into two groups and vaccinated three times. Group A received 42 µg HBsAg for each vaccination. Group B received 84 µg for the first and 21 µg for the second and third vaccinations. The seroconversion rate was 32.7% after the first, 78.8% after the second, and 95.7% after the third vaccination. The participants who failed to produce anti-HBs titer (3 IU/l;n=9) or whose anti-HBs titers were below 50 IU/l (n=31) were vaccinated a fourth time. Only mild side effects of injections were observed in a third of all participants, usually in the form of a sore arm. Between groups A and B there were no significant differences as far as the seroconversion rate and anti-HBs titer were concerned. Nonresponders plus low-responders accounted for 19%. Female participants produced a markedly higher anti-HBs titer than males, and the female/male ratio among non- and low-responders was 1:2; among nonresponders, 1:2.5. There was a negative correlation of the anti-HBs titer with the age of the participants. These results not only have practical consequences for revaccination policy, but also offer the opportunity to further study the genetic regulation of the immune response to a complex peptide antigen in man.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01712053
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