Diagnosis of Helicobacter pylori infection by invasive and noninvasive tests

Although several invasive and noninvasive tests have been developed for the diagnosis of Helicobacter pylori infection, all of the tests have their limitations. We conducted a study to investigate and compare the suitability of rapid urease test (RUT), serology, histopathology and stool antigen tests with polymerase chain reaction (PCR) for detection of H. pylori, and correlate the diagnostic methods with PCR. Eighty nine patients (61 adults, 28 children) referred to the Firoozgar Hospital and Children Medical Center Hospital for diagnostic upper gastrointestinal endoscopy entered to the study and noninvasive tests such as immunoassay for serological antibodies against H. pylori and detection of its antigen in feces were measured. The biopsies were utilized for histological examination, RUT and PCR. The H. pylori statuses were evaluated by the positivity of ureC PCR in biopsy specimens and 53 subjects had H. pylori positive result. Histopathology showed high overall performance in adults and children with sensitivity and specificity 100% and 90%, respectively. Sensitivity, specificity, and accuracy for stool antigen test were 87.8%, 75% and 82%, respectively. Correlation of RUT, serology (IgG), histopathology and stool antigen tests with PCR were 0.82, 0.32, 0.91 and 0.63, respectively. In conclusion, the RUT and histopathology are as accurate as the PCR of biopsy and stool antigen test can consider as appropriate noninvasive test for detection of H. pylori infection.

Experiences Living with Fatigue in Iranian Veterans Chemically Injured by Sulfur Mustard Gas: A Phenomenological Study

PURPOSE: Fatigue affects the quality of life. Evidence shows that the phenomenon of fatigue is experienced differently depending on the type of disease and its consequences. The aim of the study was to explicate the meanings of the experience of living with fatigue in chemically injured veterans. METHODS: The hermeneutic phenomenology approach was used in this study, with an emphasis on Van Mennen's viewpoint and approach. According to Van Mennen, six overlapping dynamic activities are recommended to conduct a phenomenological study. During unstructured interviews, the participants were asked to describe their daily living experiences with fatigue. The participants were individuals who were chemically injured due to exposure to mustard gas. After examining every statement in the interview text, extractions of the meaning units, clustering, and themes were performed. RESULTS: The data explication was based on the third to sixth stages of Van Mennen's approach. The experience living with fatigue was classified into four essential themes: fatigue as a chronic condition, as an unstable and affected situation, as a physical condition of the entire individual, and as a mental condition of the entire individual. CONCLUSION: Due to unique social interactions and pathogenicity, victims of mustard gas experience fatigue differently than patients with other chronic diseases.

efficacy of a 1-week triple therapy for eradication of Helicobacter pylori infection in children

Poor compliance to therapy and antibiotic resistance are the main causes for failure of anti-Helicobacter pylori [H. pylori] therapy. The purpose of this study was to assess the effectiveness of omeprazole-based triple therapy in Iranian children. Fifty-seven children with H. pylori-related gastroduodenal disease received 1-week triple therapy with a combination of omeprazole, amoxicillin and clarithromycin [according to the susceptibility test]. Success of eradication was assessed by [13]C-urea breath test and endoscopy. Sixty-four patients [mean age 11.3 years; range 2.7-16 years] were included. Eradication was successful in 84.2% [95% confidence interval, 72.8% intention to treat]. One-week triple therapy was effective for the eradication of H. pylori infection in children

[Effects of cool dialysate temperature on stabilizing hemodynamic parameters in diabetic patients undergoing hemodialysis]

Hypotension is the most common acute complication of hemodialysis. To ameliorate symptomatic hypotiension during dialysis, cool temperature dialysate has been recommended. Since reports show that not all patients benefit from cool dialysis, it seems necessary to determine which patients benefit more from cool dialysis. The aim of this study is to investigate the effect of cool dialysis on hemodynamic parameters in diabetic patients; serum nitric oxide levels also were determined to find any possible association. Twenty diabetic patients [mean age 63.3 +/- 7.5] were included in the study. Each patient was dialyzed twice, once using cool and once using warm dialysate solution. Apart from a change in temperature to 35°C, all other conditions remained the same during the study. Hemodynamic parameters including SBP, DBP, and HR were measured hourly, the number of hypotension episodes was also determined. Oral temperature was measured before and after dialysis. Serum urea and nitric oxide metabolites [NOx] were determined before and after hemodialysis. SBP, DBP, and MAP decreased significantly during warm, as compared to cool, dialysis. Maximum decreases in SBP, DBP, and MAP were seen in the third hour of dialysis and these were 18, 17, and 14 percent for warm and 6, 1, and 4 percent for cool dialysis respectively. HR showed no significant difference between the two groups. Compared to before dialysis, NOx levels decreased significantly in cool and warm conditions after dialysis [59 +/- 5 vs. 37 +/- 4, and 63 +/- 7 vs. 41 +/- 5, respectively, P<0.01]. Cool dialysis could decrease episodes of hypotension and stabilize hemodynamic parameters in diabetic patients. Mechanisms other than increased serum nitric oxide levels are involved in hemodialysis hypotension in diabetic patients

Effect of treadmill exercise training on VO2 peak in chronic obstructive pulmonary disease

Impairment of exercise tolerance in chronic respiratory disorders and in particular, chronic obstructive pulmonary disease [COPD], has important implications on health-related quality of life, hospitalization rate and survival. Although COPD patients have shortness of breath, programmed exercise can increase the activity tolerance in these patients. Maximal oxygen uptake [VO2 peak] is a fundamental measure of exercise physiology. It is an index of cardiovascular performance as well as a measure of aerobic capacity. VO2 max can be measured by expensive devices or predicted by a valid formula. The objective of this study was to determine the effect of treadmill exercise training [TET] on patients with chronic obstructive pulmonary disease after a 4-week program. Thirty-eight subjects with COPD were recruited in the study and were randomly divided into two groups of control [n=18] and treatment [TET, n=20]. The control group did not do any treadmill exercise training [TET]. The treatment group exercised on a treadmill three times a week. VO2 max was assessed in each group before and after the training period by using a modified formula. After 4 weeks of training, VO2 peak was significantly greater in the TET group. Considering the increase in VO2 peak, It was concluded that TET benefits exercise performance, inspiratory muscle strength, dyspnea and health-related quality of life

Survey the effect of aerobic exercise on aerobic capacity in patients with coronary artery disease [CAD]

Increased aerobic exercise capacity appears to reduce both all-cause mortality and cardiovascular disease mortality. Physical exercise to improve maximal oxygen consumption [VO2max] is thus strongly recommended, however evidence regarding the most efficient training intensity for patients with coronary artery disease [CAD] is still lacking. The purpose of this randomized study was to assess the effects of aerobic exercise for increasing VO2max in stable CAD-patients. Thirty stable CAD-patients were randomized to supervised walking 30 min three times a week for 10 weeks. Before and after training VO2max was predicted from Bruce treadmill test. Before training VO2max was 35.2 +/- 4.32ml/kg/min and after training the mean Vo2max was 43.1 +/- 3.4ml/kg/min. This difference was significant [p<0.05]. Aerobic exercise is effective for increasing VO2max in stable CAD-patients. As VO2max seems to reflect a continuum between health and cardiovascular disease and death, the present data may be useful in designing effective training programmes for improved health in the future