Mucosal serotonin signaling is altered in chronic constipation but not in opiate-induced constipation.

Objectives: Changes in mucosal serotonin (5-HT) signaling have been detected in a number of functional and inflammatory disorders of the gastrointestinal (GI) tract. This study was undertaken to determine whether chronic constipation (CC) is associated with disordered 5-HT signaling and to evaluate whether constipation caused by opiate use causes such changes.

Methods: Human rectal biopsy samples were obtained from healthy volunteers, individuals with idiopathic CC, and individuals taking opiate medication with or without occurrence of constipation.

NIH consensus development statement on management of hepatitis B.

Objective: To provide health care providers, patients, and the general public with a responsible assessment of currently available data on the management of hepatitis B.

Participants: A non-DHHS, nonadvocate 12-member panel representing the fields of hepatology and liver transplantation, gastroenterology, public health and epidemiology, infectious diseases, pathology, oncology, family practice, internal medicine, and a public representative. In addition, 22 experts from pertinent fields presented data to the panel and conference audience.

An official ATS statement: hepatotoxicity of antituberculosis therapy.

Drug-induced liver injury (DILI) is a problem of increasing significance, but has been a long-standing concern in the treatment of tuberculosis (TB) infection. The liver has a central role in drug metabolism and detoxification, and is consequently vulnerable to injury. The pathogenesis and types of DILI are presented, ranging from hepatic adaptation to hepatocellular injury.

Coinfection with HIV and hepatitis C virus in injection drug users and minority populations.

Coinfection with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) is common. In the United States, it has been estimated that 25% of persons infected with HIV are also infected with HCV. The prevalence of coinfection with HIV and HCV is highest among those infected via percutaneous routes.

Prospective multicenter study of eligibility for antiviral therapy among 4,084 U.S. veterans with chronic hepatitis C virus infection.

Background: Many veterans may not be candidates for hepatitis C virus (HCV) treatment due to contraindications to therapy. The aims of this study were to determine the proportion of HCV-infected veterans who were eligible for interferon alfa and ribavirin therapy and to evaluate barriers to HCV treatment.

Methods: We prospectively enrolled 4,084 veterans who were referred for HCV treatment over a 1-yr period at 24 Veterans Affairs (VA) Medical Centers.

More severe parenchymal injury in chronic hepatitis C acquired by recent injection drug use.

Objective: Histologic liver injury is reported to be less severe in persons who acquire hepatitis C through injection drug use (IDU) than by blood transfusion. Because age correlates with histologic severity, it may be that differences between routes of acquisition reflect the younger age of most drug abusers. The early histopathologic changes of hepatitis C acquired through IDU are less defined, probably because of the lack of liver biopsy material from a cohort of patients not long after initial exposure.

Light, but not heavy alcohol drinking, stimulates paraoxonase by upregulating liver mRNA in rats and humans.

Paraoxonase 1 (PON) may contribute to the cardioprotective action of high-density lipoprotein (HDL) because it inhibits low-density lipoprotein (LDL) oxidation, a prerequisite for the onset of atherosclerosis. Because light drinking and heavy drinking have diametrically opposite effects on cardioprotection, we have determined the effects of ethanol dosage on rat serum PON activity and its hepatic expression. Furthermore, we have investigated PON activity and polymorphism in human light and heavy drinkers.

Low-positive anti-hepatitis C virus enzyme immunoassay results: an important predictor of low likelihood of hepatitis C infection.

Background: Tests for hepatitis C antibodies (anti-HCV enzyme immunoassays) are usually described as positive or negative. Several studies, mainly in blood donors, have found that specimens with low signal/cutoff (S/C) ratios are commonly negative when tested with a recombinant immunoblot assay (RIBA) or for HCV RNA.

Methods: We retrospectively reviewed 17 418 consecutive anti-HCV results from a screening program for high-risk veterans; 2986 (17.

Understudied populations with hepatitis C.

Managing patients with hepatitis C virus (HCV) infection consists primarily of antiviral treatment, currently with peginterferon and ribavirin. Unfortunately, treatment recommendations derive largely from trials that have focused on highly selected patient populations. As a consequence of the strict inclusion and exclusion criteria in these studies, more than half of all HCV-infected patients would be ineligible for enrollment.

Use of complementary and alternative medicine in patients with liver disease.

Objectives: Complementary and alternative medicine (CAM) is used by 42% of the U.S. population.

Hepatitis C: a brief clinical overview.

Hepatitis C has emerged as an important public health problem that has affected 3.9 million Americans and 170 million people worldwide and is currently the most common indication for orthotopic liver transplantation. The disease, characterized by asymptomatic onset, is often discovered incidentally through blood tests obtained during routine physical examination or before blood donation.

High-density lipoproteins from human alcoholics exhibit impaired reverse cholesterol transport function.

We have previously shown that chronic alcohol consumption leads to inhibition of sialylation of apolipoprotein E (apo E) that results in its impaired binding to high-density lipoprotein (HDL) molecule. Because apo E plays a major role in reverse cholesterol transport (RCT), we speculated that ethanol-mediated formation of HDL molecules without apo E may affect the RCT process. Therefore, we have investigated whether the RCT function of HDL is affected in chronic alcoholics with or without liver disease compared with nondrinkers.

Intratumoral therapy of cisplatin/epinephrine injectable gel for palliation in patients with obstructive esophageal cancer.

Obstructing esophageal cancer produces severe dysphagia with ensuing death within 90 days. Palliation is possible with modalities like stent placement, laser, and photodynamic therapy. However, these treatments have a high rate of complications, and the overall mortality is not altered.

The natural history of chronic hepatitis C infection.

Hepatitis C is among the most common causes of chronic liver disease affecting approximately 1% of the world's population. End-stage hepatitis C virus (HCV)-related chronic liver disease is the leading indication for orthotopic liver transplantation worldwide. Despite these facts, many questions regarding the natural history of HCV infection remain unanswered.

New hepatitis A vaccines and their role in prevention.

The hepatitis A virus (HAV) accounts for 20 to 25% of clinically apparent hepatitis cases worldwide. It generally causes mild to moderately severe acute illness. The serological prevalence of this virus is high in underdeveloped countries where poor sanitary conditions facilitate the spread of the virus.

Determinants of metastatic rate and survival in patients with Zollinger-Ellison syndrome: a prospective long-term study.

Background/aims: It is unclear whether tumor location, size, or the presence of multiple endocrine neoplasia type 1 (MEN-1) alters metastatic rate and survival in patients with pancreatic endocrine tumors. The purpose of this study was to determine the prognostic factors of survival and metastatic rate in patients with Zollinger-Ellison syndrome (ZES).

Methods: Data were analyzed from 185 consecutive patients with ZES who were followed up prospectively.

Esophageal function and occurrence of Barrett's esophagus in Zollinger-Ellison syndrome.

Manifestations of esophageal disease are present in up to 60% of patients with Zollinger-Ellison syndrome (ZES), although esophageal function has been studied in only a few patients and the prevalence of Barrett's mucosa is unknown in these patients. It is unclear whether the high prevalence of esophageal disease is related to gastric acid hypersecretion alone or to abnormalities of esophageal motility or lower esophageal sphincter (LES) function in addition. To address these issues in the present study esophageal function was evaluated prospectively in 92 consecutive patients with ZES (66 with active disease, 26 disease-free after curative resection) seen during a 1-year period after controlling acid hypersecretion.

Inhibitory cyclic analogues and chlorambucil derivatives of bombesin-like peptides.

Analogues of the amphibian neuropeptide, bombesin, and of the mammalian homologue, gastrin-releasing peptide, have been synthesized and their biological activity studied in small cell lung carcinoma and rat pancreatic acinar cells. The compounds are truncated sequences of the active tetradecapeptide BN(1-14) or GRP(20-27). Peptides were cyclized between position 5 or 7 and the carboxyl end of the des-Met14 fragment with D and L Ala11 and Lys5 substitutions, as well as various N-terminal groups attached.