ABSTRACT
Introducción: la infección con Helicobacter pylori (H. pylori) y la eficacia de las pruebas serológicas para su diagnóstico presentan variabilidad entre diferentes regiones geográficas. Objetivo: el objetivo del presente trabajo fue determinar la eficacia de la serología como diagnóstico de infección por H. pylori y el mejor valor de corte para la población local. Materiales y métodos: se evaluaron 48 pacientes, 27 hombres y 21 mujeres, con una edad promedio de 29.2 años. En cada paciente se realizaron 3 pruebas para el diagnóstico de H. pylori: erología dosaje de anticuerpos tipo IgG (MÉTODO), serología dosaje de anticuerpos de tipo IgA (MÉ- TODO) e histología. Se obtuvieron los parámetros de eficacia y la curva de rendimiento diagnóstico de la serología IgG e IgA utilizando a la histología como estándar ideal. Resultados: el punto de corte de mayor eficacia para la serología IgG fue de 16 U/ml [sensibilidad 81%, especificidad 65%, valor predictivo positivo (VPP) 81%, valor predictivo negativo (VPN) 65% y exactitud diagnóstica 75%] y para la serología IgA fue de 17 U/ml (sensibilidad 61%, especificidad 53%, valor redictivo positivo 70%, valor predictivo negativo 43% y exactitud diagnóstica 58%). El área bajo la curva fue de 67% (IC 95%: 50 a 84) y de 54.4% (IC 95%: 38 a 72) para la IgG e IgA respectivamente. Conclusiones: la serología es una herramienta valiosa para el diagnóstico de infección por H. pylori en nuestra oblación donde hay alta prevalencia, especialmente por su bajo costo y fácil realización, pero fue necesaria una disminución del valor de corte sugerido para obtener mayor eficacia diagnóstica.
Introduction: The infection with Helicobacter pylori (H. pylori), and the diagnostic efficacy of the serologic tests has certain variability among the different geographic regions. Objective: The objective of the present work was to find the local validation of serological methods for diagnosis of H. pylori infection and to determine the best cutoff value for the local population. Materials and methods: Forty-eight patients were evaluated, 27 males and 21 females, with a mean age of 29.2 years. On each patient, 3 tests for H. pylori diagnosis were performed: IgG serology, IgA serology, and histology. We performed IgG and IgA serologic test for H. pylori infection and a histological examination for each patient. Efficacy parameters as well as the ROC curve were obtained for the IgG and IgA serology using histology as the gold standard. Results: The cutoff point with the highest efficacy for IgG serology was 16 U/ml (sensitivity 81%, specificity 65%, positive predictive value 81%, negative predictive value 65%, and accuracy 75%), and for IgA serology was 17 U/ml (sensitivity 61%, specificity 53%, positive predictive value 70%, negative predictive value 43%, and accuracy 58%). The area under the curve was 67.1% (CI 95%: 50 to 84.1) and 54.4% (CI 95%: 38.3 to 72.5) for IgG and IgA respectively. Conclusion: The serology is a valuable tool in our population with high prevalence of H. pylori, especially due to its low cost and easy performance, but a reduction of the cutoff value was necessary to obtain more sensibility and a more adequate identification of true positives cases.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Helicobacter Infections/diagnosis , Immunoglobulin A/blood , Immunoglobulin G/blood , Cohort Studies , Cross-Sectional Studies , Ecuador , Sensitivity and Specificity , Serologic Tests/methods , Serologic Tests/standards , Urban PopulationABSTRACT
INTRODUCTION: This aim of our experimental study was to demonstrate the versatility of our designed reusable decive for PEG and its future application in humans. MATERIALS AND METHODS: 20 mongrel dogs received enteral nutrition by a Foley tube placed by a single endoscopic technique using a reusable stainless steel designed decive, three reusable stainless steel designed decive, three reusable stainless steel dilators, an Olympus XQ20 video gastrointestinal endoscope, basic surgical equipment and surgical material. RESULTS: The procedure was successfully performed in all dogs under general anaesthesia. The duration of the whole procedure ranged from 10 to 18 min. The complications regardless by the PEG procedure were minimal. The Foley tube was retained by 15 days. CONCLUSIONS: The application of the stainless steel reusable designed decive for the PEG is safe, and presents several advantages. This technique for PEG placement could be used in the future due the characteristics of the designed device: durable and reusable for unlimited number of procedures.