Can fall in anti-H. pylori IgG titres indicate eradication?

At present, it is not clear whether a fall in serological titres of anti-H. pylori IgG can be used for confirming eradication. A prospective study was conducted using varying cut-off levels from (10% to 50%) fall in anti-H. pylor IgG levels as a test of eradication in comparison to urease and histology. It was found that sensitivity was highest using a 10% cut-off but specificity wasvery low. Increasing cut-off values increased specificity but resulted in declining sensitivity without altering accuracy much. It appears that in the short term, percentage decline in serological titres can at best serve as a crude test of eradication.

Malondialdehyde levels in patients with duodenal ulcer.

Malondialdehyde (MDA) is a stable product of lipid peroxidation of membrane lipids. In view of its role in membrane lipid damage in various inflammatory disorders, MDA levels were estimated in 83 duodenal ulcer patients and 48 controls. MDA levels were found to be significantly higher in duodenal ulcer patients as compared to controls (mean +/- SD 280.2 +/- 109.0 versus 216.5 +/- 81.4 nm/dL, p < 0.001). These increased levels of MDA may represent either the result of peroxidative damage in the disease process or a pathogenetic factor enhancing the risk for duodenal ulcer.

Serum pepsinogen levels in patients with gastro-duodenal lesions.

Serum pepsinogen (SP) levels were studied in 100 patients with gastroduodenal lesions, and 100 healthy volunteers. SP levels were significantly elevated in patients with duodenal ulcer (DU) and duodenitis compared to the controls. SP values above 150 ug Tyr/ml/24 hr were highly suggestive of duodenal ulcer disease. Age and sex of patients and controls did not influence SP levels. The mean values of SP in North India were found to be lower in both normal and DU subjects compared to the west.

Platelet serotonin uptake in duodenal ulcer patients.

Platelet serotonin uptake was measured in 10 duodenal ulcer patients and 10 controls by determining the concentration of radioactivity in platelets after incubation with tritium-labelled serotonin binoxalate. Platelet 5-HT uptake in ulcer patients (312.0 +/- 125.0 CPM/10(7) platelets) was significantly higher than that in the control group (186.0 +/- 53.0 CPM/10(7) platelets; p < 0.01). Since the kinetics of 5-HT uptake by platelets may be a reflector of enhanced serotonergic activity, this finding may have implications in future therapeutic strategies for this disease.

HLA, grupo sanguineo, factor secretor, pepsinogeno I y helicobacter pylori en ulcerosos duodenales / HLA, blood group, secretor factor, pepsinogen I and helicobacter pylori in duodenal ulcer patients

La Ulcera duodenal es una entidad multifactorial en donde la predisposición genética y elementos extrínsecos parecen concurrir en su producción. Se determinaron una serie de marcadores genéticos y extrínsecos en 50 ulcerosos duodenales y 50 controles, pareados por edad, sexo y origen socieconómico. La detención del antígeno HLA no mostró diferencias significativas. Predominó el grupo sanguíneo ORh+ (p < 0.01). El factor secretor de antígeno ABO en saliva fue positivo en el 70 por ciento de los ulcerosos (p < 0.001). El Pepsinógeno I sérico resultó elevado en 85 por ciento de los pacientes (p < 0.001). La Inmunoglobina G anti H. pylori fue positiva en 62 por ciento de los ulcerosos (p < 0.001). La mayor sensibilidad y valor predictivo negativo lo tuvo el Pepsinógeno elevado (85 por ciento ) y la mayor especificidad y valor predictivo positivo la IgG anti H. pylori (90 y 86 por ciento ). Estos resultados, al mostrar positividad de marcadores genéticos e infecciosos afirman el carácter poligénico de la enfermedad ulcerosa duodenal

Niveles de pepsinógeno I sérico en descendientes de ulcerosos duodenales / Levels of blood pepsinogen I in the offspring of patients with duodenal ulcer

La hiperpepsinogenemia I es un fidedigno marcador subclínico de predisposición genética a sufrir úlcera duodenal, por ello determinamos los niveles basales de pepsinógeno I (PG I) sérico en 25 ulcerosos y el 75

Early onset duodenal ulcer with special reference to serum alpha-1-antitrypsin activity.

Thirteen patients of duodenal ulcer, below 20 years of age, ten age and sex matched controls and 17 first probands were studied to find out (i) the special characteristics of this duodenal ulcer subtype and (ii) the serum alpha-1-antitrypsin (alpha-1-AT) activity in these patients and their first probands. Basal and maximal acid output, and serum level of alpha-1-AT were measured, and serum agar gel electrophoresis done, in the above subjects. Special characteristics like positive family history, and high basal (p less than or equal to 0.01) and maximal (p less than or equal to 0.001) acid output were noted in these patients. Serum alpha-1-AT was found to be deficient in nine patients. Five first probands also had the heterozygous level of the enzyme deficiency. Thus, patients of early onset duodenal ulcer seem to have special characteristics with alpha-1-antitrypsin deficiency in them as well as in their first probands.

Niveles de pepsinógeno I sérico en el ulceroso duodenal sangrante / Serum pepsinogen I levels in bleeding duodenal ulcerous

Se compararon los niveles de Pepsinógeno I (PG I) séricos de 25 ulcerosos duodenales con antecedentes de sangramiento (UDS), 25 ulcerosos duodenales no sangrantes (UDNS) y un grupo control, igualmente distribuídos por edad y sexo. El valor más elevado que en los UDNS, esta diferencia sin embargo, no fue estadísticamente significativa. No obstante, el 88%de los UDS presentaron valores de PG I elevados comparados con el 72%de los uDNS. Dichos grupos si tuvieron diferencia significativa (p<0.001) con el grupo control. Concluímos que la medición del PG I sérico, es un sensible método diagnóstico complementario en el ulceroso duodenal. Su capacidad discriminatoria como índice de severidad, por el antecedente de hemorragia, sin embargo, no pudo ser demostrado. La hemorragia sigue siendo unreto en la historia natural del ulceroso duodenal

Pepsinógeno I sérico y enfermedad ulcerosa duodenal / Serum pepsinogen I and duodenal ulcer disease

La úlcera duodenal es una enfermedad frcuente. Se ha dicho siempre que resulta de un inadecuado balance entre las fuerzas agresivas (HC1 y pepsina) y las fuerzas defensivas. Tradicionalmente mayor atención se ha prestado al ácido y relativo menor interés a la pepsina. Dos tipo de pepsinógenos han sido reconocidos como precursores de la actividad péptica intraluminal. El Pepsinógeno I ha sido mayormente implicado en ulcerogénesis. La intención de esta revisión es considerar los diferentes aspectos actuales fisiopatológicos y clínicos, como marcador predictivo y genético de esta enzima en la enfermedad ulcerosa duodenal, la cual es siempre un reto en la práctica diaria de los gastroenterólogos

Alpha-1-antitrypsin activity in duodenal ulcer.

Alpha-1-antitrypsin activity was estimated in thirty-one duodenal ulcer patients and twenty-five age and sex matched controls. Statistically significant (P less than 0.05) decrease was noted in the mean alpha-1-antitrypsin activity in the patients sera. These observations indicate that alpha-1-antitrypsin deficiency may be one of the important factors in the aetiopathogenesis of duodenal ulcer in a considerable proportion of patients.

Pepsinogênio I e úlcera duodenal / Serum pepsinogen I and duodenal ulcer

Neste artigo de revisäo procurou-se enfocar o papel do pepsinogênio/pepsina desde sua descoberta até sua aplicaçäo prática que, à semelhança do teste de secreçäo gástrica de ácido clorídrico, apresenta padröes diferentes de secreçäo basal ou estimulada na úlcera péptica, gastrite etc. Säo avaliados os métodos de determinaçäo do pepsinogênio, verificando-se que apesar da utilizaçäo do radioimunoensaio, outros métodos menos sofisticados, porém com alta especificidade, têm sido usados com sucesso. Os níveis séricos de pepsinogênio (NSP) após estímulo com Histalog discriminam pacientes com úlcera duodenal de indivíduos normais e säo mais elevados em homens do que em mulheres. É feito um paralelismo entre os pepsinogênios I e II verificando-se níveis mais elevados do pepsinogênio I em fumantes. O pepsinogênio I está aumentado na úlcera duodenal e o II na úlcera gástrica, e os dois tendem a caracterizar uma predisposiçäo genética para úlcera péptica. Finalmente, a principal aplicabilidade clínica da determinaçäo dos NSP do grupo I é na detecçäo da gastrite atrófica, em funçäo de seu potencial para o cáncer gástrico

Níveis séricos do pepsinogênio em pacientes normais e em portadores de úlceras gastroduodenais: simplificaçäo da técnica / Serum levels of pepsinogen in patients with gastrointestinal ulcer and in controls: a simplified technic

Prospectivamente, avaliou-se o comportamento dos níveis séricos do pepsinogênio (NSP) em 17 pacientes portadores de úlcera gástrica, sendo nove de úlcera duodenal e oito normais. Nos oito pacientes normais, os NSP foram determinados em condiçöes basais e após a estimulaçäo com Betazole**R, aos 60, 90, 120, 150 e 180 minutos. Nos pacientes ulcerosos gastroduodenais, os NSP mostraram-se estatisticamente diferentes, quando comparados aos pacientes normais. Estatisticamente, em todos os grupos estudados, após a estimulaçäo com Betazole, näo houve diferença significativa nos valores obtidos aos 60, 90 e 120 minutos. Dessa forma, em condiçöes basais e após 90 minutos de estímulo com Betazole**R, seria possível utilizar apenas duas coletas para a determinaçäo dos NSP. Quando se realiza a interpretaçäo em condiçöes basais e com três medidas, o método fornece o mesmo número de informaçöes. A simplificaçäo metodológica, no momento, proposta, representa progressos na procura de prova que substitua a trabalhosa e incômoda dosagem da acidez gástrica

Correlation of blood groups with congenital disorders and gastro intestinal diseases.

Blood group studies were conducted in 330 patients suffering from gastro intestinal disorders and 180 patients with congenital malformations and compared with normal subjects. Statistical analysis has shown that (a) there is significant correlation between B group and thalassaemia, (b) congenital malformations show higher incidence in B and O groups. It would be pertinent to draw attention to the fact that B group was found to be significantly correlated to duodenal ulcer from the present study contrary to the early reports. In addition, these observations show that blood groups are linked with diseases.

Serum and red cell cholinesterase activity in duodenal ulcer.

Sixty-eight patients suffering from active duodenal ulcer (diagnozed radiologically) were examined for serum cholinesterase (50 patients) and red cell cholinesterase (18 patients) activity. In all these patients serum or red cell cholinesterase activity were found to be significantly low when compared with 56 normal individuals (controls). The low level of cholinesterase activity may be regarded as a pathogenic component of duodenal ulcer.