ABSTRACT
Background: Infection with Helicobacter pylori is frequent in Chile, and a good test for its diagnosis ideally should be non-invasive, fast, easy and inexpensive. Aim: To report the use of an immunoassay test, that detects antigens of Helicobacter pylori in stools. Material and methods: One hundred and four patients that required an upper gastrointestinal endoscopy were studied. Stool samples were analyzed using an enzymatic immunoassay. These results were compared with those obtained with the urease test and microscopic examination of smears taken from biopsies obtained during the diagnostic endoscopy. Results: In 81 of 83 patients considered to have the infection according to the endoscopic tests, the antigen was also present in the stools. The test was negative in 16 of 21 patients considered to be without the infection. The resulting sensitivity and specificity for the immunoassay was thus 97.6 and 76.2 percent respectively, with positive and negative predictive values of 92.4 and 88.9 percent, respectively. Conclusions: These results are in agreement with those reported in the literature. Further studies are needed to define its usefulness in massive screening, follow up after antibiotic treatments or the detection of coccoid forms of Helicobacter pylori
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Helicobacter pylori , Helicobacter Infections , Feces , Enzyme-Linked Immunosorbent AssayABSTRACT
Desde fines del siglo XIX, con la utilización de los rayos X, aparecieron las primeras descripciones de lesiones ocasionadas por la radiación abdominal y pelviana. Luego, en la segunda mitad del siglo XX se perfeccionaron los equipos de radiación que se utilizaron en el tratamiento del cáncer. Desde esa fecha, se multiplicaron los pacientes con afección actínica de algún segmento del tubo digestivo. La radiación produce en el intestino: a) lesiones agudas en las primeras semanas, generalmente autolimitadas, que habitualmente no requieren manejo específico y b) lesiones crónicas que aparecen entre 6 meses a 2 años y se caracterizan por dolor abdominal, diarrea y sangrado digestivo, junto con las complicaciones como fístulas, estenosis y perforación, que son subsidiarias de terapias de elevada complejidad y morbimortalidad. Entre los métodos diagnósticos se incluye la colonoscopía, que muestra lesiones en la mucosa intestinal tanto en la fase aguda como en la crónica, con edema, granularidad, friabilidad, lesiones vasculares telangiectásicas y eventualmente ulceraciones o estenosis con pérdida de pliegues y haustras. La radiología contrastada con bario muestra dilatación de asas, edema de la mucosa, pérdida de haustras o pliegues, estenosis y fístula o perforación en la fase más crónica. La tomografía axial computada proporciona ayuda en la pesquisa de complicaciones como abscesos o perforación y en el diagnóstico diferencial de carcinoma versus lesión actínica. Las medidas terapéuticas incluyen apoyo nutricional y sintomático en fase aguda. En la fase crónica, a lo anterior se agregan terapias endoscópicas como aplicación de formalina tópica, coagulación con plasma argón o argón láser. Finalmente, frente a complicaciones como estenosis, fístula o perforación, se plantea el tratamiento quirúrgico
Subject(s)
Humans , Colitis/etiology , Enteritis/etiology , Radiotherapy/adverse effects , Radiation Injuries/epidemiology , Causality , Radiation Injuries/prevention & control , Radiation Injuries/therapyABSTRACT
Most nonsteroidal antiinflammatory drugs can produce hepatotoxicity. We report a 22 years old female who presented with an acute cholestatic hepatitis after a prolonged period of piroxicam use. Hepatitis was attributed to this drug since all markers for hepatitis virus (A, B, C, E, Epstein Barr, Cytomegalovirus and Herpex Simplex) were negative, autoimmune markers were negative, serum iron and ceruloplasmin were normal, there was a temporal relationship between the administration of piroxicam and the hepatitis, the histological picture was compatible with this etiology and the patient had a favorable evolution after the discontinuance of the drug. This type of hepatotoxicity is not common but it must be born in mind when patients must receive nonsteroidal antiinflammatory drugs for prolonged periods