Nuevo método para detección de infección y erradicación del Helicobacter pylori (Hp) por determinaciòn de antígenos en meteria fecal / A new method for detection H. pylori infection and erradication by stool antigen test

Nowadays technics for Helicobacter pylori detection in stools like culture, and PCR, are expensive and difficult to perform. The aim of this study was to evaluate ELISA test efficacy for detection of H. Pylori antigens in stools comparing this results with standarized technics like histology (Giemsa), ureasa test and UBT C 14. 26 patients were evaluated in this study, ages between 15-75 with upper gastrointestinal symptoms; all of them required gastroduodenal endoscopy, status H. Pylori was determined with methods upon mentioned. 24 hours after endoscopy H. Pylori antigens in stools with the technique Premier Platinum Htsa, Elisa were determined. The detection of H. Pylori antigens in stools accurately identified active H. Pylori infection. The performance characteristics of this non-invasive method was similar in sensibility and specificity to conventional tests

Nuevo método para detección de infección y erradicación del Helicobacter pylori (Hp) por determinaciòn de antígenos en meteria fecal / A new method for detection H. pylori infection and erradication by stool antigen test

Nowadays technics for Helicobacter pylori detection in stools like culture, and PCR, are expensive and difficult to perform. The aim of this study was to evaluate ELISA test efficacy for detection of H. Pylori antigens in stools comparing this results with standarized technics like histology (Giemsa), ureasa test and UBT C 14. 26 patients were evaluated in this study, ages between 15-75 with upper gastrointestinal symptoms; all of them required gastroduodenal endoscopy, status H. Pylori was determined with methods upon mentioned. 24 hours after endoscopy H. Pylori antigens in stools with the technique Premier Platinum Htsa, Elisa were determined. The detection of H. Pylori antigens in stools accurately identified active H. Pylori infection. The performance characteristics of this non-invasive method was similar in sensibility and specificity to conventional tests (AU)

[Virtual gastroscopy. Preliminary experience]. / Gastroscopía virtual. Experiencia preliminar.

OBJECTIVE: To define the role of virtual gastroscopy (VG) in the detection of elevated lesions comparing its results with conventional endoscopy (CE) as the gold standard method. MATERIALS AND METHODS: Between December 2000 and July 2001, 19 patients were evaluated. The age ranged between 41 and 72 (mean 58.8 years old). VG and CE were performed in all the patients during the same week. VG were carried out with a multislice CT scanner (Mx 8000, Marconi Medical Systems). The technical parameters used were 3 mm with slices and 1.5 mm reconstruction intervals. The acquisition time was 22 seconds. Images were sent to a workstation (MxView, Marconi Medical Systems) where they were reprocessed in three different ways: 1) Bidimensionally 2) Tridimensionally 3) Virtual Endoscopy Findings of VG were compared with CE. RESULTS: VG detected 39 lesions, whereas CE detected 40 lesions. There were 39 true-positive findings, 2 true-negative findings, 0 false-positive findings and 1 false-negative findings. The Sensitivity (Se) was 97.5%; Specificity (Sp) was 100%, positive predictive value 100% and Negative predictive value 66%. CONCLUSIONS: VG is a new non-invasive method with high Se and Sp in the detection of elevated lesions. The actual role of VG consist in identification of gastric lesions and possibility to diagnose gastric disease.

Gastroscopía virtual: experiencia preliminar / Virtual gastroscopy: preliminary experience

OBJECTIVE: To define the role of virtual gastroscopy (VG) in the detection of elevated lesions comparing its results with conventional endoscopy (CE) as the gold standard method. MATERIALS AND METHODS: Between December 2000 and July 2001, 19 patients were evaluated. The age ranged between 41 and 72 (mean 58.8 years old). VG and CE were performed in all the patients during the same week. VG were carried out with a multislice CT scanner (Mx 8000, Marconi Medical Systems). The technical parameters used were 3 mm with slices and 1.5 mm reconstruction intervals. The acquisition time was 22 seconds. Images were sent to a workstation (MxView, Marconi Medical Systems) where they were reprocessed in three different ways: 1) Bidimensionally 2) Tridimensionally 3) Virtual Endoscopy Findings of VG were compared with CE. RESULTS: VG detected 39 lesions, whereas CE detected 40 lesions. There were 39 true-positive findings, 2 true-negative findings, 0 false-positive findings and 1 false-negative findings. The Sensitivity (Se) was 97.5%; Specificity (Sp) was 100%, positive predictive value 100% and Negative predictive value 66%. CONCLUSIONS: VG is a new non-invasive method with high Se and Sp in the detection of elevated lesions. The actual role of VG consist in identification of gastric lesions and possibility to diagnose gastric disease

Gastroscopía virtual: experiencia preliminar / Virtual gastroscopy: preliminary experience

OBJECTIVE: To define the role of virtual gastroscopy (VG) in the detection of elevated lesions comparing its results with conventional endoscopy (CE) as the gold standard method. MATERIALS AND METHODS: Between December 2000 and July 2001, 19 patients were evaluated. The age ranged between 41 and 72 (mean 58.8 years old). VG and CE were performed in all the patients during the same week. VG were carried out with a multislice CT scanner (Mx 8000, Marconi Medical Systems). The technical parameters used were 3 mm with slices and 1.5 mm reconstruction intervals. The acquisition time was 22 seconds. Images were sent to a workstation (MxView, Marconi Medical Systems) where they were reprocessed in three different ways: 1) Bidimensionally 2) Tridimensionally 3) Virtual Endoscopy Findings of VG were compared with CE. RESULTS: VG detected 39 lesions, whereas CE detected 40 lesions. There were 39 true-positive findings, 2 true-negative findings, 0 false-positive findings and 1 false-negative findings. The Sensitivity (Se) was 97.5%; Specificity (Sp) was 100%, positive predictive value 100% and Negative predictive value 66%. CONCLUSIONS: VG is a new non-invasive method with high Se and Sp in the detection of elevated lesions. The actual role of VG consist in identification of gastric lesions and possibility to diagnose gastric disease (AU)

[A new method for detection and erradication of Helicobacter pylori infection by stool antigens test]. / Nuevo mètodo para detecciòn de infecciòn y erradicaciòn del Helicobacter pylori (Hp) por determinaciòn de antìgenos en materia fecal.

Nowadays technics for Helicobacter pylori detection in stools like culture, and PCR, are expensive and difficult to perform. The aim of this study was to evaluate ELISA test efficacy for detection of H. Pylori antigens in stools comparing this results with standarized technics like histology (Giemsa), ureasa test and UBT C 14. 26 patients were evaluated in this study, ages between 15-75 with upper gastrointestinal symptoms; all of them required gastroduodenal endoscopy, status H. Pylori was determined with methods upon mentioned. 24 hours after endoscopy H. Pylori antigens in stools with the technique Premier Platinum Htsa, Elisa were determined. The detection of H. Pylori antigens in stools accurately identified active H. Pylori infection. The performance characteristics of this non-invasive method was similar in sensibility and specificity to conventional tests.

Gastroscopía virtual. Experiencia preliminar. / [Virtual gastroscopy. Preliminary experience]

OBJECTIVE: To define the role of virtual gastroscopy (VG) in the detection of elevated lesions comparing its results with conventional endoscopy (CE) as the gold standard method. MATERIALS AND METHODS: Between December 2000 and July 2001, 19 patients were evaluated. The age ranged between 41 and 72 (mean 58.8 years old). VG and CE were performed in all the patients during the same week. VG were carried out with a multislice CT scanner (Mx 8000, Marconi Medical Systems). The technical parameters used were 3 mm with slices and 1.5 mm reconstruction intervals. The acquisition time was 22 seconds. Images were sent to a workstation (MxView, Marconi Medical Systems) where they were reprocessed in three different ways: 1) Bidimensionally 2) Tridimensionally 3) Virtual Endoscopy Findings of VG were compared with CE. RESULTS: VG detected 39 lesions, whereas CE detected 40 lesions. There were 39 true-positive findings, 2 true-negative findings, 0 false-positive findings and 1 false-negative findings. The Sensitivity (Se) was 97.5

; Specificity (Sp) was 100

, positive predictive value 100

and Negative predictive value 66

. CONCLUSIONS: VG is a new non-invasive method with high Se and Sp in the detection of elevated lesions. The actual role of VG consist in identification of gastric lesions and possibility to diagnose gastric disease.

Nuevo mÞtodo para detecciòn de infecciòn y erradicaciòn del Helicobacter pylori (Hp) por determinaciòn de antýgenos en materia fecal. / [A new method for detection and erradication of Helicobacter pylori infection by stool antigens test]

Nowadays technics for Helicobacter pylori detection in stools like culture, and PCR, are expensive and difficult to perform. The aim of this study was to evaluate ELISA test efficacy for detection of H. Pylori antigens in stools comparing this results with standarized technics like histology (Giemsa), ureasa test and UBT C 14. 26 patients were evaluated in this study, ages between 15-75 with upper gastrointestinal symptoms; all of them required gastroduodenal endoscopy, status H. Pylori was determined with methods upon mentioned. 24 hours after endoscopy H. Pylori antigens in stools with the technique Premier Platinum Htsa, Elisa were determined. The detection of H. Pylori antigens in stools accurately identified active H. Pylori infection. The performance characteristics of this non-invasive method was similar in sensibility and specificity to conventional tests.

Deteccion del Helicobacter pylori por reaccion en cadena de polimerasa en jugo gastrico y su correlacion con la histologia (Giemza) / Helicobacter pylori detection by in gastric juice and its correlation with the histology (Giemsa)

Mediante técnicas de biología molecular (PCR), hemos podido detectar la presencia de HP en el jugo gástrico en la tercera parte (10/31 pacientes - 32,3 por ciento) de los infectados con la bacteria, según determinación histológica. La demostración de la presencia de HP en jugo gástrico permitirá a traves de nuevos estudios mejorar los conocimientos acerca de los mecanismos de diseminación y complementar la metodología diagnóstica.

Deteccion del Helicobacter pylori por reaccion en cadena de polimerasa en jugo gastrico y su correlacion con la histologia (Giemza) / Helicobacter pylori detection by in gastric juice and its correlation with the histology (Giemsa)

Mediante técnicas de biología molecular (PCR), hemos podido detectar la presencia de HP en el jugo gástrico en la tercera parte (10/31 pacientes - 32,3 por ciento) de los infectados con la bacteria, según determinación histológica. La demostración de la presencia de HP en jugo gástrico permitirá a traves de nuevos estudios mejorar los conocimientos acerca de los mecanismos de diseminación y complementar la metodología diagnóstica. (AU)

[Is dental plaque a normal Helicobacter pylori reservoir?]. / Es la placa dentaria reservorio habitual de Helicobacter pylori?

The mechanisms of transmission and reservoir of Helicobacter pylori is still unclear; even it has been suggested that dental plaque could be the bacterial reservoir and one important factor in the reinfection. The aim of the study was to evaluate the prevalence of Helicobacter pylori in dental plaque in 20 patients with non ulcer dyspepsia (12 females, 7 males; mean age 40.5 years) and antral infection; and to establish the presence of bacteria in dental plaque and gastric mucosa after eradication. Gastric colonization in all of them was confirmed by five samples (three of antrum and two of body) with Giemsa conventional technique, clotest and culture. When clotest was positive in gastric mucosa, we performed the scrape of dental plaque and sending the material for culture. All patients were treated with a scheme of seven days with one protom pump inhibitor and two antibiotics. After four weeks all the patients were controlled with endoscopy and culture of dental plaque to confirm eradication. Dental plaque culture was positive in 1/20 patients (5%), and this results was similar to developed countries, using as detection method culture or polymerase chain reaction (PCR).

Es la placa dentaria reservorio habitual de Helicobacter pylory? / Is dental plaque reservoir of Helicobacter pylori?

Si bien la forma de transmisión y el reservorio del Helicobacter pylori no son claros, se ha sugerido que la placa dentaria puede ser reservorio del germen y poseer inplicancias en la reinfección, una vez erradicada la bacteria. El objetivo de este trabajo fue evaluar la prevalencia del Helicobacter pylori en placa dentaria en 20 pacientes portadores de dispepsia no ulcerosa (12 mujeres y 7 varones con media etaria de 40.5 años)e infección antral por Helicobacter pylori y establecer la presencia en placa dentaria y mucosa gástrica luego de la erradicación. En todas ellas se confirmó la colonización gástrica mediante 5 biopsias (3 de antro y 2 de cuerpo) realizándose histología convencional com Giemsa clotest y cultivo en medio de anaerobiosis com generador de microaerofilia, usando como medio de transporte Stuard-carbón activado. Confirmada la positividad del clotest en mucosa gástrica, se procedió al raspado de placa dentaria en el servicio de odontología, enviándose el material en las mismas condiciones descriptas para el cultivo de la bacteria. Todos los pacientes fueron tratados com un esquema de erradicación a 7 días que incluía un IBP en dos tomas diarias; amoxicilina 1 gr. X 2 y claritromicina 500 mg. X 2. Cuatro semanas después de finalizado el esquema se realizó nueva endoscopía y cultivo de placa dentaria para confirmar erradicación. El cultivo de placa dentaria fue positivo en 1 de 20 es decir el 5 por ciento, confirmándose su erradicación com la terapeútica en el control a las 4 semanas. Nuestros resultados en cuanto a prevalencia de Hp en placa dentaria son similares a los obtenidos en países desarrollados, utilizando como método de detección de la bacteria el cultivo de PCR.

Es la placa dentaria reservorio habitual de Helicobacter pylory? / Is dental plaque reservoir of Helicobacter pylori?

Si bien la forma de transmisión y el reservorio del Helicobacter pylori no son claros, se ha sugerido que la placa dentaria puede ser reservorio del germen y poseer inplicancias en la reinfección, una vez erradicada la bacteria. El objetivo de este trabajo fue evaluar la prevalencia del Helicobacter pylori en placa dentaria en 20 pacientes portadores de dispepsia no ulcerosa (12 mujeres y 7 varones con media etaria de 40.5 años)e infección antral por Helicobacter pylori y establecer la presencia en placa dentaria y mucosa gástrica luego de la erradicación. En todas ellas se confirmó la colonización gástrica mediante 5 biopsias (3 de antro y 2 de cuerpo) realizándose histología convencional com Giemsa clotest y cultivo en medio de anaerobiosis com generador de microaerofilia, usando como medio de transporte Stuard-carbón activado. Confirmada la positividad del clotest en mucosa gástrica, se procedió al raspado de placa dentaria en el servicio de odontología, enviándose el material en las mismas condiciones descriptas para el cultivo de la bacteria. Todos los pacientes fueron tratados com un esquema de erradicación a 7 días que incluía un IBP en dos tomas diarias; amoxicilina 1 gr. X 2 y claritromicina 500 mg. X 2. Cuatro semanas después de finalizado el esquema se realizó nueva endoscopía y cultivo de placa dentaria para confirmar erradicación. El cultivo de placa dentaria fue positivo en 1 de 20 es decir el 5 por ciento, confirmándose su erradicación com la terapeútica en el control a las 4 semanas. Nuestros resultados en cuanto a prevalencia de Hp en placa dentaria son similares a los obtenidos en países desarrollados, utilizando como método de detección de la bacteria el cultivo de PCR. (AU)

[Helicobacter pylori detection by polymerase chain reaction in gastric juice and its correlation with the histology (Giemsa)]. / Detección del Helicobacter pylori por reacción en cadena de polimerasa en jugo gástrico y su correlación con la histología (GIEMSA).

HP infection is involved in the pathogenesis of several gastroduodenal diseases, as type B chronic gastritis, duodenal and gastric ulcer, MALT lymphoma and gastric cancer. The recent availability of molecular techniques, specifically the PCR, allow us to detect very low amounts of the bacterium. The aim of the study is to evaluate the presence of HP in gastric juice by PCR technique and to correlate this findings with histology (Giemsa) of gastric mucosa. Gastric juice PCR positive findings were found in 10/31 (32.3%) HP positive patients at histology. We concluded that HP in gastric juice is possible to detect by molecular techniques. In our study 32.3% of the patients showed the presence of HP in gastric juice.

[Evaluation of sensitivity, specificity and predictive value of six qualitative serological methods for the detection of Helicobacter pylori antibodies]. / Evaluación de sensibilidad, especificidad y valor predictivo de seis métodos serológicos cualitativos para la detección de anticuerpos contra el Helicobacter Pylori.

Screening tests for IG g antibodies against Helicobacter pylori are usefull for a long follow up of patients who were well eradicated. The aim of this study was to determinate and compared sensibility, specificity, positive and negative predictive value of six qualitative serological tests for IG g antibodies detection in the diagnosis of H. Pylori infections. Between May and October 1996 52 patients (30 males and 22 females; median age 42.4 years, range 21-68) with H. Pylori infection assessed on two antral and two corpus biopsies by means of Giema stain and a rapid urease test were tested for IG g antibodies detection. The serological tests used were: Inmunocomb II (Orgenics) Enzimo Inmuno Assay Inmunoadsorbent qualitative, Flex Pack (Smith Kline Diagnostics, Abbott) inmunocromatographic cualitative, Pylori Stat test (Biowhittaker) Enzimo Inmuno Assay (ELISA) qualitative, Premier (Meridian Diagnostics) Enzimo Inmuno Assay ELISA) qualitative. Pyloristest (Orion Diagnóstica) latex aglutination qualitative, H. Pylori (Bio Tre) Enzimo Inmuno Assay cualitative. 10 healthy subjects with negative gastric biopsies and negative rapid ureasa test were used as control group. The six evaluated serological tests have a comparable sensibility (89-95%) and specificity (77-83%) for the diagnosis of HP infection. The presence of specific HP antibodies in infected patients revealed a strong correlation with the histological demonstration of the microrganisms. We can recommend this qualitative serological tests due to their high sensibility and specificity, simplicity and low cost.

Evaluacion de sensibilidad, especificidad y valor predictivo de seis metodos serologicos cualitativos para la deteccion de anticuerpos contra el Helicobacter pylori / Evaluation of sensitivity, specificity and predictive value of six qualitative serological methods for the detection of Helicobacter pylori antibodies

El diagnóstico de infección por H.P. incluye: test rápido de la ureasa y cultivo de biopsia gástrica, urea breath test y detección de Atc Ig G. Existe una fuerte correlación entre la positividad de estos tests y la demonstración histológica de dicho microorganismo. El objetivo de nuestro trabajo fue: determinar y comparar la sensibilidad, especificidad y valor predictivo positivo y negativo de seis equipos comerciales para la detección serológica cualitativa de atc IgG, para el diagnóstico de H.P. Se estudiaron 52 pacientes (58 por ciento masculino, 42 por ciento femenino) con edad promedio 42,4 años con diagnóstico úlcera péptica gastro-duodenal o gastritis erosiva, H. Pylori positivo por test de la ureasa e histología convencional (Giemsa) en 2 biopsias de antro y 2 de cuerpo. El grupo control incluía 10 individuos con histología y test de la ureasa negativos. Los seis tests serológicos evaluados tenían sensibilidad y especificidad comparable, (89-95 por ciento) y (77-83 por ciento) respectivamente. La presencia de anticuerpos específicos contra H.P. en pacientes infectados reveló una fuerte correlación con la demonstración histológica del microorganismo. Recomendamos estos tests serológicos cualitativos debido a su alta sensibilidad y especificidad, bajo costo, sencillez y rapidez para su realización. (AU)

Evaluacion de sensibilidad, especificidad y valor predictivo de seis metodos serologicos cualitativos para la deteccion de anticuerpos contra el Helicobacter pylori / Evaluation of sensitivity, specificity and predictive value of six qualitative serological methods for the detection of Helicobacter pylori antibodies

El diagnóstico de infección por H.P. incluye: test rápido de la ureasa y cultivo de biopsia gástrica, urea breath test y detección de Atc Ig G. Existe una fuerte correlación entre la positividad de estos tests y la demonstración histológica de dicho microorganismo. El objetivo de nuestro trabajo fue: determinar y comparar la sensibilidad, especificidad y valor predictivo positivo y negativo de seis equipos comerciales para la detección serológica cualitativa de atc IgG, para el diagnóstico de H.P. Se estudiaron 52 pacientes (58 por ciento masculino, 42 por ciento femenino) con edad promedio 42,4 años con diagnóstico úlcera péptica gastro-duodenal o gastritis erosiva, H. Pylori positivo por test de la ureasa e histología convencional (Giemsa) en 2 biopsias de antro y 2 de cuerpo. El grupo control incluía 10 individuos con histología y test de la ureasa negativos. Los seis tests serológicos evaluados tenían sensibilidad y especificidad comparable, (89-95 por ciento) y (77-83 por ciento) respectivamente. La presencia de anticuerpos específicos contra H.P. en pacientes infectados reveló una fuerte correlación con la demonstración histológica del microorganismo. Recomendamos estos tests serológicos cualitativos debido a su alta sensibilidad y especificidad, bajo costo, sencillez y rapidez para su realización.