Can urea breath test (UBT) replace rapid urea test (RUT)?

BACKGROUND: Helicobacter pylori (Hp) is classified by the International Agency for Research on Cancer (IARC) as a Group 1 carcinogen. Its influence on the carcinogenesis of gastric cancer has been confirmed in many researches. The conclusion is obvious- early detection and eradication of Hp can prevent the development of the disease. METHODS: The objective of the study was to analyse the clinical and practical value of Carbon-13 urea breath test (UBT) in patients hospitalized due to pain complaints in the upper abdomen and dyspeptic symptoms. Fifty patients were enrolled in the study. Each patient underwent urea breath test according to the instruction included by the producer. Thereafter, each patient included in the study group was performed endoscopy of the upper gastrointestinal tract with the biopsy of the mucosa to determine the urease activity with rapid urease test (RUT). RESULTS: In the study group, 14 patients (28%) achieved a positive urease test result which was confirmed in RUT. Four (8%) patients, despite a positive breath test, did not have a positive result in urease activity from gastric mucosa. In 2 cases (4%) despite negative result of UBT there was urease actitvity confirmed in gastroscopic sections. The remaining 30 patients (60%) had a negative result in both studies. CONCLUSIONS: The limited availability of the gold standard for diagnostics of upper gastrointestinal tract diseases (gastroscopy) is the basis for the search for new methods for the detection of Helicobacter pylori infection. The urea breath test is a method of high sensitivity and specificity. The positive result of urea breath test may be the basis for the inclusion of eradication therapy.

Helicobacter pylori urease for diagnosis of Helicobacter pylori infection: A mini review.

The stomach contents contain of both acid and proteolytic enzymes. How the stomach digests food without damaging itself remained a topic of investigation for decades. One candidate was gastric urease, which neutralized acid by producing ammonia from urea diffusing from the blood and potentially could protect the stomach. Discovery that gastric urease was not mammalian resulted in a research hiatus until discovery that gastric urease was produce by Helicobacter pylori which caused gastritis, peptic ulcer and gastric cancer. Gastric urease allows the organism to colonize the acidic stomach and serves as a biomarker for the presence of H. pylori. Important clinical tests for H. pylori, the rapid urease test and urea breath test, are based on gastric urease. Rapid urease tests use gastric biopsies or mucus placed in a device containing urea and an indicator of pH change, typically phenol red. Urea breath tests measure the change in isotope enrichment of 13C- or 14CO2 in breath following oral administration of labeled urea. The urea breath test is non-invasive, convenient and accurate and the most widely used test for non-invasive test for detection of active H. pylori infection and for confirmation of cure after eradication therapy.

Diagnostic accuracy of the 14C-urea breath test in Helicobacter pylori infections: a meta-analysis.

OBJECTIVES: To summarize and appraise the available literature regarding the use of the 14C-urea breath test in the diagnosis of Helicobacter pylori infections in adult patients with dyspepsia and to calculate pooled diagnostic accuracy measures. METHODS: We systematically searched the PubMed, EMBASE, Cochrane Library, Chinese Journals Full-text (CNKI) and CBMDisc databases to identify published data regarding the sensitivity, specificity, and other measures of diagnostic accuracy of the 14C-urea breath test in the diagnosis of Helicobacter pylori infections in adult patients with dyspeptic symptoms. Risk of bias was assessed using the QUADAS (Quality Assessment of Diagnostic Accuracy Studies)-2 tool. Statistical analyses were performed using Meta-Disc 1.4 software and STATA. RESULTS: Eighteen studies met the inclusion criteria. Pooled results indicated that the 14C-urea breath test showed a diagnostic sensitivity of 0.96 (95% CI 0.95 to 0.96) and specificity of 0.93 (95% CI 0.91 to 0.94). The positive like ratio (PLR) was 12.27 (95% CI 8.17 to 18.44), the negative like ratio (NLR) was 0.05 (95% CI 0.04 to 0.07), and the area under the curve was 0.985. The DOR was 294.95 (95% CI 178.37 to 487.70). The 14C-urea breath test showed sufficient sensitivity and specificity for diagnosing Helicobacter pylori infection, but unexplained heterogeneity after meta-regression and several subgroup analyses remained. CONCLUSIONS: The UBT has high accuracy for diagnosing H. pylori infections in adult patients with dyspepsia. However, the reliability of these diagnostic meta-analytic estimates is limited by significant heterogeneity due to unknown factors.

The pharmacology study result of kidney inflammation treatment active preparation / Монголын Анагаах Ухаан

IntroductionNumber of kidney acute and chronic disease is increasing rapidly in the world and becoming the majorcause of death even population employment capacity is invalid. Statistical report of Mongolian Ministryof Health last 5 years statistic kidney disease is in the 3rd of non-contagious disease Synthetic andchemical medicines used for this sort of disease would have side effects in some cases. Plants, animalsand minerals biologically active substances, side effects need to produce new drugs, has attracted theattention of researches.GoalIdentifying pharmacology act of new granule medicine preparation.Material and Methods: The effects of the medicinal substances were investigated on “WISTAR” linesof white rat. Pathological model of nephritis was formed by injected the rats with kanamycin sulfate(Mondodoev.A.J, Lameza.S.B, Bartonov.E.A, 1988). The experimental animals were given any of thenew granular herbal medicine and compared to the rats given Nefromon. After treatment the creatinine,urea acid and MDA in the serum were determined. MDA is identified by an amount of concentration andmethod (Stalinaya. I.D. 1977).ResultCreatinine amount of disease model group of kidney illness created by kanamycin sulfate is comparedwith healthy group animals and 1.64 times, carbamide amount is 4.25 times, rest of the azote’s 2.73are increased and comparing the experiment group creatinine amount is 1.65 creatinine amount is 1.65decreased comparing with disease model group.ConclusionWhen compound ingredients preparation creates experiment animal kanamycin sulfate oxidantdominates, intensify the kidney cell active, decrease the carbamide and creatinine and decrease thekidney cell necrosis.

Comparison of 2 methods for determining vascular access recirculation rate in hemodialysis patients / 第二军医大学学报

Objective: To study the application of glucose infusion test (GIT) in assaying the vascular access recirculation rate in hemodialysis patients. Methods: Access recirculation was assayed by both urea test (UT) and GIT in 82 hemodialysis patients, and 17 patients were also examined by Doppler ultrosonics method. The results of the Doppler ultrosonics were compared with those of UT and GIT. Results: Thirty-seven (45.12%) patients showed positive results with GIT and 29 patients (35.36%) with UT.All 17 patients had recirculation confirmed by Doppler ultrosonics and all had positive results by GIT (100%), but only 9 (52.94%) of the 17 patients had positive results by UT. Conclusion: Comapared with UT, GIT is more sensitive, more ecnomical,and simpler in determining vascular access recirculation, and can be used as a new method for screening vascular access recirculation.