RESUMO
Nowadays technics for Helicobacter pylori detection in stools like culture, and PCR, are expensive and difficult to perform. The aim of this study was to evaluate ELISA test efficacy for detection of H. Pylori antigens in stools comparing this results with standarized technics like histology (Giemsa), ureasa test and UBT C 14. 26 patients were evaluated in this study, ages between 15-75 with upper gastrointestinal symptoms; all of them required gastroduodenal endoscopy, status H. Pylori was determined with methods upon mentioned. 24 hours after endoscopy H. Pylori antigens in stools with the technique Premier Platinum Htsa, Elisa were determined. The detection of H. Pylori antigens in stools accurately identified active H. Pylori infection. The performance characteristics of this non-invasive method was similar in sensibility and specificity to conventional tests (AU)
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Antígenos de Bactérias/análise , Fezes/microbiologia , Infecções por Helicobacter/diagnóstico , Helicobacter pylori/imunologia , Técnicas Imunoenzimáticas/métodos , Ensaio de Imunoadsorção Enzimática/normas , Sensibilidade e EspecificidadeRESUMO
Nowadays technics for Helicobacter pylori detection in stools like culture, and PCR, are expensive and difficult to perform. The aim of this study was to evaluate ELISA test efficacy for detection of H. Pylori antigens in stools comparing this results with standarized technics like histology (Giemsa), ureasa test and UBT C 14. 26 patients were evaluated in this study, ages between 15-75 with upper gastrointestinal symptoms; all of them required gastroduodenal endoscopy, status H. Pylori was determined with methods upon mentioned. 24 hours after endoscopy H. Pylori antigens in stools with the technique Premier Platinum Htsa, Elisa were determined. The detection of H. Pylori antigens in stools accurately identified active H. Pylori infection. The performance characteristics of this non-invasive method was similar in sensibility and specificity to conventional tests
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Antígenos de Bactérias , Fezes , Infecções por Helicobacter , Helicobacter pylori , Técnicas Imunoenzimáticas , Ensaio de Imunoadsorção Enzimática , Sensibilidade e EspecificidadeRESUMO
Nowadays technics for Helicobacter pylori detection in stools like culture, and PCR, are expensive and difficult to perform. The aim of this study was to evaluate ELISA test efficacy for detection of H. Pylori antigens in stools comparing this results with standarized technics like histology (Giemsa), ureasa test and UBT C 14. 26 patients were evaluated in this study, ages between 15-75 with upper gastrointestinal symptoms; all of them required gastroduodenal endoscopy, status H. Pylori was determined with methods upon mentioned. 24 hours after endoscopy H. Pylori antigens in stools with the technique Premier Platinum Htsa, Elisa were determined. The detection of H. Pylori antigens in stools accurately identified active H. Pylori infection. The performance characteristics of this non-invasive method was similar in sensibility and specificity to conventional tests.
Assuntos
Antígenos de Bactérias/análise , Fezes/microbiologia , Infecções por Helicobacter/diagnóstico , Helicobacter pylori/imunologia , Técnicas Imunoenzimáticas/métodos , Adolescente , Adulto , Idoso , Ensaio de Imunoadsorção Enzimática/normas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade e EspecificidadeRESUMO
Nowadays technics for Helicobacter pylori detection in stools like culture, and PCR, are expensive and difficult to perform. The aim of this study was to evaluate ELISA test efficacy for detection of H. Pylori antigens in stools comparing this results with standarized technics like histology (Giemsa), ureasa test and UBT C 14. 26 patients were evaluated in this study, ages between 15-75 with upper gastrointestinal symptoms; all of them required gastroduodenal endoscopy, status H. Pylori was determined with methods upon mentioned. 24 hours after endoscopy H. Pylori antigens in stools with the technique Premier Platinum Htsa, Elisa were determined. The detection of H. Pylori antigens in stools accurately identified active H. Pylori infection. The performance characteristics of this non-invasive method was similar in sensibility and specificity to conventional tests.
RESUMO
BACKGROUND: Less than 15% of patients with chronic hepatitis C show a sustained virological response to interferon treatment. AIM: To evaluate the efficacy and safety of different doses of ketoprofen combined with interferon-alpha 2b in the treatment of chronic hepatitis C. PATIENTS/METHODS: Seventy compensated patients with chronic hepatitis C received interferon-alpha 2b 3 million units three times a week for six months. They were randomly assigned to: group 1 (n = 23), interferon-alpha 2b alone; group 2 (n = 23), interferon-alpha 2b plus 200 mg ketoprofen three times a week; group 3 (n = 24), interferon-alpha 2b plus 200 mg ketoprofen twice a day. Complete and sustained responses were defined as normal serum alanine aminotransferase levels and negative serum hepatitis C virus RNA at six and 12 months respectively. RESULTS: Complete and sustained responses were similar in groups 1 and 2: 10% v 5% and 5% v 0% respectively. In group 3, complete response was 29% (p = 0.13 v group 1 and p = 0.04 v group 2) and sustained response was 26% (p = 0.07 v group 1 and p = 0.01 v group 2). Overall, adverse events were similar in the three groups. However, 'flu-like syndrome was less common in group 2 (30%) and group 3 (37%) than in group 1 (77%) (p = 0.01). CONCLUSIONS: Twice daily ketoprofen administration combined with interferon-alpha 2b produced an increase in complete and sustained responses. Although the combination of interferon-alpha 2b with ketoprofen was well tolerated and decreased the incidence of 'flu-like syndrome, it is advisable to monitor possible non-steroid anti-inflammatory drug hepatotoxicity.
Assuntos
Anti-Inflamatórios não Esteroides/administração & dosagem , Antivirais/administração & dosagem , Hepatite C Crônica/tratamento farmacológico , Interferon-alfa/administração & dosagem , Cetoprofeno/administração & dosagem , Esquema de Medicação , Quimioterapia Combinada , Feminino , Humanos , Interferon alfa-2 , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Proteínas RecombinantesRESUMO
OBJECTIVE: Several studies have demonstrated that chronic exposure to gluten may damage the structure and function of the gastric mucosa in gluten-sensitive patients. However, until now, these abnormalities have been incompletely studied. Our purpose in the present study was to characterize, in a prospective controlled study, the endoscopic and histological appearance of the gastric mucosa in a large cohort of patients with celiac disease with and without Helicobacter pylori (H. pylori) infection. METHODS: We evaluated biopsy specimens taken from the gastric body and antrum of 218 individuals who underwent upper endoscopy for small bowel biopsy. One hundred-four patients had celiac disease (80 of them at the time of diagnosis-untreated). In 114 subjects celiac disease was excluded. RESULTS: Endoscopic findings did not show a difference between the groups. The prevalence of cases with normal gastric mucosa, chronic superficial gastritis, and atrophic gastritis was similar in patients and controls. Similarly, presence of metaplasia, inflammatory activity, and lymphoid follicles and aggregates did not show differences between the groups. Histological or serological evidence of H. pylori infection was detected in 86% of patients (82% of untreated celiacs and 95% of those on those taking treatment). The infection was highly prevalent in patients (89%) and controls (97%) diagnosed with chronic gastritis. Untreated patients had a significant greater IEL count in the antrum and corpus than controls (p < 0.0001 and p < 0.001, respectively). A global analysis of the data on intraepithelial lymphocyte (IEL) counts in the different populations suggest that the inflammatory state may represent the cumulative effect of H. pylori infection and gluten sensitivity. Only three patients had IEL infiltration compatible with diagnosis of lymphocytic gastritis (count >25%) and three other patients had borderline counts. CONCLUSIONS: According to our results, celiac disease patients presented a similar prevalence of gastric mucosal abnormalities compared with the control population. Evidence of H. pylori infection was very high compared with the prevalence in the general Argentine population. As a particular observation in our celiac population, the disease was rarely associated with lymphocytic gastritis. We suggest that the chronic inflammatory state evidenced by a gastric mucosal lymphocyte infiltration may be secondary to the combination of H. pylori infection and chronic gluten ingestion in gluten-sensitive subjects.
Assuntos
Doença Celíaca/patologia , Mucosa Gástrica/patologia , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Doença Celíaca/complicações , Doença Celíaca/dietoterapia , Feminino , Gastrite/complicações , Gastrite/patologia , Gastroscopia , Infecções por Helicobacter/complicações , Helicobacter pylori , Humanos , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
Our aim was to compare standard liver function tests (serum bilirubin, serum albumin and prothrombin concentration), with lidocaine and monoethylglycinexylidide pharmacokinetic parameters, after oral lidocaine administration, to assess hepatic function of cirrhotic individuals. Twenty-one consecutive cirrhotic patients, nine consecutive acute hepatitis patients, and nine healthy individuals received oral lidocaine. Lidocaine and monoethylglycinexylidide serum concentrations were determined by the TDx system. Cirrhotic patients had higher lidocaine and lower monoethylglycinexylidide serum concentrations and differences in its pharmacokinetic variables, compared to control and hepatitis groups (P < 0.05). Sensitivity of lidocaine serum determinations (100%) was greater than sensitivity of serum bilirubin (57%), serum albumin (62%), and prothrombin concentrations (43%) and monoethylglycinexylidide serum concentrations (57%) in differentiating cirrhotic individuals from controls. In conclusion, after oral administration, lidocaine and monoethylglycinexylidide pharmacokinetic parameters are significantly altered in cirrhotic patients compared to normal and acute hepatitis subjects. Lidocaine pharmacokinetic parameters would be better than those of monoethylglycinexylidide and standard liver function tests in the evaluation of liver function of cirrhotic patients.
Assuntos
Lidocaína/análogos & derivados , Lidocaína/farmacocinética , Cirrose Hepática/sangue , Testes de Função Hepática/normas , Administração Oral , Adulto , Análise de Variância , Área Sob a Curva , Bilirrubina/sangue , Feminino , Meia-Vida , Hepatite A/sangue , Hepatite A/metabolismo , Hepatite A/fisiopatologia , Hepatite B/sangue , Hepatite B/metabolismo , Hepatite B/fisiopatologia , Humanos , Lidocaína/administração & dosagem , Lidocaína/sangue , Cirrose Hepática/metabolismo , Cirrose Hepática/fisiopatologia , Masculino , Pessoa de Meia-Idade , Tempo de Tromboplastina Parcial , Sensibilidade e Especificidade , Albumina Sérica , Índice de Gravidade de DoençaRESUMO
BACKGROUND/AIMS: Selective intestinal decontamination has been proposed to prevent spontaneous bacterial peritonitis in cirrhosis. Because of the cost of antibiotics and the development of resistant bacteria, we have evaluated the effect of different schemes and doses of oral ciprofloxacin on aerobic gram-negative fecal flora in cirrhotic patients. METHOD: Twenty-nine cirrhotic patients were allocated to four groups to receive: Group 1: 500 mg/day for 2 weeks (six patients); Group 2: 1000 mg twice a week for 2 weeks (six patients); Group 3: 1000 mg once a week for 2 weeks (six patients); and Group 4: 1000 mg once a week for 12 weeks (11 patients). Quantitative analysis of the gram-negative fecal flora was performed before and 1 and 2 weeks after initiation of treatment in patients in Groups 1, 2 and 3 and before and 4, 8 and 12 weeks after initiation of treatment in patients in Group 4. RESULTS: Complete eradication of gram-negative bacilli was observed in four of six patients in Group 1. In contrast, only one patient eradicated gram-negative bacilli in Group 2 and Group 3. In long-term administration of ciprofloxacin (Group 4), only two of 11 patients had persistent eradication of gram-negative bacilli. Four patients developed E. coli resistant to ciprofloxacin (one of them associated to resistant Klebsiella). No patient developed bacterial infection during the study period. CONCLUSION: Oral ciprofloxacin administered in a weekly dose is ineffective in selective intestinal decontamination. Different mechanisms, including the emergence of ciprofloxacin-resistant organisms, could account for this failure. Therefore, our results suggest that weekly administration of ciprofloxacin is not useful in preventing spontaneous bacterial peritonitis.
Assuntos
Anti-Infecciosos/uso terapêutico , Ciprofloxacina/uso terapêutico , Fezes/microbiologia , Bactérias Aeróbias Gram-Negativas/efeitos dos fármacos , Cirrose Hepática/tratamento farmacológico , Peritonite/prevenção & controle , Administração Oral , Adulto , Idoso , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Humanos , Cirrose Hepática/microbiologia , Masculino , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
Screening tests for IG g antibodies against Helicobacter pylori are usefull for a long follow up of patients who were well eradicated. The aim of this study was to determinate and compared sensibility, specificity, positive and negative predictive value of six qualitative serological tests for IG g antibodies detection in the diagnosis of H. Pylori infections. Between May and October 1996 52 patients (30 males and 22 females; median age 42.4 years, range 21-68) with H. Pylori infection assessed on two antral and two corpus biopsies by means of Giema stain and a rapid urease test were tested for IG g antibodies detection. The serological tests used were: Inmunocomb II (Orgenics) Enzimo Inmuno Assay Inmunoadsorbent qualitative, Flex Pack (Smith Kline Diagnostics, Abbott) inmunocromatographic cualitative, Pylori Stat test (Biowhittaker) Enzimo Inmuno Assay (ELISA) qualitative, Premier (Meridian Diagnostics) Enzimo Inmuno Assay ELISA) qualitative. Pyloristest (Orion Diagnóstica) latex aglutination qualitative, H. Pylori (Bio Tre) Enzimo Inmuno Assay cualitative. 10 healthy subjects with negative gastric biopsies and negative rapid ureasa test were used as control group. The six evaluated serological tests have a comparable sensibility (89-95%) and specificity (77-83%) for the diagnosis of HP infection. The presence of specific HP antibodies in infected patients revealed a strong correlation with the histological demonstration of the microrganisms. We can recommend this qualitative serological tests due to their high sensibility and specificity, simplicity and low cost.
Assuntos
Anticorpos Antibacterianos/isolamento & purificação , Helicobacter pylori/imunologia , Imunoglobulina G/isolamento & purificação , Adulto , Idoso , Feminino , Infecções por Helicobacter/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Testes SorológicosRESUMO
Se realizo la determinacion de Lp-x por la -9, 1981 y cuantitativo fue efectuado en el suero de treinta y cinco pacientes colestaticos, comparado con un grupo testigo en los que no se detecto la presencia de esta lipoproteina.Los resultados de este estudio afirman, que el hallazgo de esta lipoproteina significa un marcado avance en el diagnostico de la colestasis. Remarcamos su importancia como un metodo diagnostico superior a las pruebas bioquimicas clasicas
Assuntos
Colestase , Lipoproteína-XRESUMO
Se realizo la determinacion de Lp-x por la -9, 1981 y cuantitativo fue efectuado en el suero de treinta y cinco pacientes colestaticos, comparado con un grupo testigo en los que no se detecto la presencia de esta lipoproteina.Los resultados de este estudio afirman, que el hallazgo de esta lipoproteina significa un marcado avance en el diagnostico de la colestasis. Remarcamos su importancia como un metodo diagnostico superior a las pruebas bioquimicas clasicas