RESUMO
INTRODUCTION AND OBJECTIVES: The EncephalApp Stroop Test was developed to more easily diagnose minimal hepatic encephalopathy (MHE). A cut-off of >274.9sec (ONtime+OFFtime) reached a 78% sensitivity and 90% specificity in the validation study, but it has been poorly studied in Brazil. We aim to analyze the usefulness of this diagnostic method and to describe a cut-off value to screen MHE in Brazil. METHODS: In this cross-sectional and single-center study, three positive psychometric tests defined the diagnosis of MHE as the gold standard. We evaluated gender, age, education, familiarity with smartphones, etiology of cirrhosis, Child-Pugh/MELD scores, and previous hepatic encephalopathy (HE). Healthy controls and patients without HE were compared for the task validation. The Chi-square and Mann-Whitney tests, logistic regression analysis, and ROC curves were used for statistical evaluation. RESULTS: We included 132 patients with cirrhosis (61% male) and 42 controls (62% male) around 51y. Sixty-three were diagnosed with MHE on psychometric tests and 23 had clinical HE. Viral hepatitis (38%) was the major etiology of cirrhosis. The median MELD was 10 and Child-Pugh A was more frequent (70%). There was no significant difference in test results between controls and patients without HE. There was also no influence of gender, age, education, and familiarity with smartphones in the test results. Child-Pugh A was associated with MHE (p=0.0106). A cut-off of >269.8sec (ONtime+OFFtime) had an 87% sensitivity and 77% specificity to detect MHE (p=0.002). CONCLUSION: This is a valid and reliable tool for screening MHE. However, optimal cut-off values need to be validated locally.
Assuntos
Cognição/fisiologia , Diagnóstico Precoce , Encefalopatia Hepática/diagnóstico , Programas de Rastreamento/métodos , Teste de Stroop , Adolescente , Adulto , Idoso , Brasil/epidemiologia , Estudos Transversais , Feminino , Seguimentos , Encefalopatia Hepática/epidemiologia , Encefalopatia Hepática/fisiopatologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Curva ROC , Estudos Retrospectivos , Adulto JovemRESUMO
A infecçäo pelo Heliocobacter Pylori está relacionada a várias doenças digestivas. A sorologia é um método diagnóstico näo-invasivo e de baixo custo. Contudo, os kits comerciais apresentam eficácia em geral variável. O HM-CAP, um método imunoenzimático que detecta IgG específica anti-H. pylori, foi avaliado. Foram estudados 77 pacientes com sintomatologia dispéptica e com resultados de histologia, cultura e urease compatíveis. Os soros destes pacientes foram submetidos ao ensaio e os resultados, comparados com os outros exames. Assim, a sensibilidade do HM-CAP foi de 88,1 por cento; a especificidade, de 61,1 por cento; o valor preditivo positivo, de 88,1 por cento; o valor preditivo negativo, de 61,1 por cento; a prevalência, de 76,6 por cento; e a acurácia, de 81,8 por cento. Näo houve diferença significativa quanto a sensibilidade e especificidade entre os grupos de indivíduos com idades acima e abaixo de 45 anos