Objetivo: Determinar la prevalencia de Helicobacter pylori en pacientes sintomáticos de consulta externa en la Red Rebagliati (EsSalud) en el período 2010-2013. Materiales y métodos: Estudio observacional, transversal y analítico. Se revisaron los registros de pacientes ambulatorios con la prueba en aliento con urea-13C diagnóstica de Helicobacter pylori en el período 2010-2013. Resultados: De los 1711 pacientes, la prevalencia global de Helicobacter pylori fue 45,5% (IC 95%: 43,17- 47,89), siendo mayor en mujeres que en varones (47,1% vs. 42,1%, p=0,056). Hubo diferencias significativas en la edad entre infectados y no infectados (44 vs. 39, p<0,05), con asociación entre la edad y presencia de Helicobacter pylori (p<0,001). La prevalencia estimada en la población pediátrica fue 36,3% y se encontró resultado positivo en 201 (51,1%) mujeres en edad fértil. La mayoría (43,9%) procedían del sector financiero de la ciudad. Conclusiones: La prevalencia de Helicobacter pylori en la población de estudio fue similar en ambos sexos y tuvo relación con la edad. El nivel socioeconómico medio de Lima mantiene la prevalencia de Helicobacter pylori reportada en los últimos años.

Faculty of Health Scicence School of Medicine 0100107g johannes.geyer@wits.ac.za / The 14C and 13C labelled urea breath tests (UBT) for detecting Helico-bacter pylori infection are well established but scope for improvement exists in both to reduce some of their shortcomings. For this study, the 14C UBT investigation focussed on reducing the quantity of radioactive tracer that is administered to the subject un-dergoing this test, with the aim of lowering the radiation dose to the patient, reducing the impact to the environment and exempting the test from radioactive materials licensing. Wider acceptance, availabil-ity, affordability to lower socio-economic groups and third party medi-cal treatment payers and using readily available equipment were fac-tors considered when developing the method. The principle of the method developed is to collect larger volume breath sample, quantitatively absorbing a defined volume of extracted breath CO2 in an efficient CO2 trapping agent using a specifically de-signed apparatus and measuring the activity with a low background β-spectrometer. A reduction in the quantity of 14C labelled urea administered to the pa-tient was achieved. The method also reduced the counting error mar-gin at a lower detection limit, improving discrimination between H. py-lori positive and negative patients. iii The 13C UBT is a non-radioactive test however, it is substantially more expensive. The 13C UBT investigation aimed to determine whether commercially available un-enriched urea could be used thus reducing the cost of the 13C UBT. A simple protocol with Isotope Ratio Mass Spectrometry (IRMS) for the measurement was used as opposed to the well-established 13C UBT protocol. The principle of the 13C UBT investigation was to detect the change of the breath δ13C (13C/12C) ratio after the administration of un-enriched urea with a δ13C different to the exhaled breath. Theoretical calculations showed that an administered dose of 500mg un-enriched urea with at least a 10‰ δ13C difference may be detectable using IRMS. In vitro investigations confirmed that levels of 0.01 to 0.001‰ δ13C were detectable by IRMS. A change in the δ13C of a standard breath CO2 was confirmed for a range between 0.14 to 50% v/v mixed CO2 samples, i.e. the projected range for in-vivo investigation. Results from the in-vivo investigation however were not able to distinguish positive from negative H. pylori patients. The use of the 1000mg dose of urea appears to have caused saturation of the enzyme. It was con-cluded that some enrichment of the 13C is necessary or less urea be used.

Please read the abstract in the section front of this document / Dissertation (MSc)--University of Pretoria, 2007. / Chemical Pathology / unrestricted

Background: Pulmonary Embolism (PE) is a potentially life-threatening condition that is characterized by one or several blood clots blocking the arteries in the lungs. The existing diagnostic tools for PE have their shortcomings, highlighting the importance of investigating new diagnostic methods. The development of non-invasive methods to collect microparticles from exhaled breath has opened possibilities to explore new potential biomarkers. SensAbues® is a sampling device that utilizes electrostatic filters to capture microparticles from the exhaled breath. The objective of this project was twofold: firstly, to assess the suitability of SensAbues® sampling device for a future proteomics study where the goal is to identify biomarkers for PE; and secondly, to evaluate the efficacy of various extraction solutions in retrieving proteins from the electrostatic filters. Materials and methods: Samples were collected from three healthy volunteers using the SensAbues® device. The electrostatic filters were then extracted using either PBS or 15% ethanol and the protein content was then estimated using a modified Bradford method. Additionally, two blank SensAbues® filter extracts, from PBS and 15% ethanol were analyzed using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Results: The attempts to evaluate extraction solutions using the Bradford method were unsuccessful, as all the samples yielded negative values. The filter-blank extracts analyzed with LC-MS/MS contained a significant amount of polyethylene glycols of varying sizes. Conclusion: The polyethylene glycols from the SensAbues® filters may have interfered with the Bradford method. Polyethylene glycols can also interfere with proteins, making the SensAbues® sampling device unsuitable for the prospective proteomics study.

Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2015-05-25T13:09:16Z No. of bitstreams: 2 Tese - Felix André Sanches Penhavel - 2014.pdf: 2537517 bytes, checksum: 2edff02f8a1f3fa50c180c2222a53b17 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2015-05-25T13:34:49Z (GMT) No. of bitstreams: 2 Tese - Felix André Sanches Penhavel - 2014.pdf: 2537517 bytes, checksum: 2edff02f8a1f3fa50c180c2222a53b17 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2015-05-25T13:34:49Z (GMT). No. of bitstreams: 2 Tese - Felix André Sanches Penhavel - 2014.pdf: 2537517 bytes, checksum: 2edff02f8a1f3fa50c180c2222a53b17 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2014-12-15 / American Tripanosomiasis is one of the most prevalente tropical disease in Latin America. One third of brazilian territory is considered endemic for Chagas disease. Vectorial transmission is not complitely interrupted. In Central Brazil, specially Goiás State, digestive forms with megasyndormes have a high frequence. The involvement of small bowel has been discribed with functional disturbances. Patients with acquired megacolon may have normal bowel movements or long lasting constipation. Until now the influence of small bowel on the frequence of bowel movements is not clear. This prospective study addressed the small bowel motility measuring the orocecal transit time (OCTT) and the occurence of small bowel intestinal bacterial overgrowth (SIBO) by hydrogen breath test. 45 patients with positive serology for Chagas disease were divided into four groups: A – without megacolon and no constipation (17); B – with megacolon and no constipation (8); C – with megacolon and constipation (10) and D – without megacolon and constipation (10). Constipation was defined by at least 7 days without bowel movements. 15 healthy volunteers were taken as a control group (CG). Non hydrogen producers: 10/45 patients and 1/15 controls. The OCTT (medium time in minutes) was longer in patients than in controls: A=108.18, B=108.0, C=112.5, D=130.0 and CG=68.46. Patients together showed difference compared to controls (P=0.001). No difference was found among groups (P>0.05). The prevalence of SIBO was: 66.7% in constipated patients (C and D), 25% in non constipated patients (A and B) and 8.3% in controls. Significant statistical difference was found only comparing constipated patients and controls (P=0.017). The presence of megacolon did not show influence the frequence of SIBO (P=0.181). Lactose and D-xylose malabsorption was higher in controls. The number of patients with symptoms during the test was the same for chagasic and controls independently of the test result. Patients with Chagas disease have a prolonged OCTT and those with constipation showed a higher prevalence of SIBO and both factors are not related to megacolon. Chagasic patients showed a less frequency of lactose and D- xylose malabsorption. / A Tripanossomíase Americana é uma das doenças tropicais mais prevalentes na América Latina. Mais de um terço do território brasileiro é área endêmica, e a transmissão vetorial ainda não se interrompeu em todos os estados. Em Goiás, as megassíndromes do tubo digestivo são muito frequentes. O comprometimento do tubo digestivo não se restringe à víscera dilatada e alterações funcionais têm sido descritas no intestino delgado. O objetivo geral deste estudo foi investigar alterações de motilidade e de absorção de carboidratos no intestino delgado de pacientes chagásicos com e sem constipação e megacólon. Avaliou-se 45 pacientes com sorologia positiva para doença de Chagas, divididos em quatro grupos: A - sem constipação, sem megacólon (17); B - sem constipação, com megacólon (8); C - com constipação, com megacólon (10) e D - com constipação, sem megacólon (10). Quinze voluntários sadios foram usados como controles (GC). Todos os pacientes e controles realizaram três testes respiratórios com os substratos: lactulose, lactose e D-xilose. Identificou-se não produção de hidrogênio em 10 pacientes e um controle. O tempo de trânsito orocecal (TTOC) (média em minutos) foi maior nos pacientes do que nos controles: A=108,18; B=108,0; C=112,5; D=130,0 e GC=68,46 (P=0,001). Não houve diferença no TTOC entre os grupos de pacientes (P<0,05). A prevalência de supercrescimento bacteriano no intestino delgado (SBID) foi de 66,7% nos pacientes constipados (C e D), 25% nos não constipados (A e B) e de 8,3% nos controles (P=0,017). A presença de megacólon não influenciou a frequência de SBID (P=0,181). A má absorção de lactose foi maior entre os controles. O número de pacientes que apresentava sintomas ou não durante o teste da lactose foi igual para pacientes e controles, independentemente do resultado do teste. A má absorção de D-xilose foi mais frequente no grupo controle. Concluiu-se que os pacientes chagásicos têm o tempo de trânsito orocecal prolongado e que aqueles com constipação apresentam uma maior prevalência de SBID, ambos os fatores não sofrem influência da presença do megacólon. A má absorção de lactose e D-xilose foi maior entre controles.

Helicobacter pylori-infektion är en av de ledande orsakerna till utvecklingen av maligniteter i ventrikeln. Tillämpning av pålitliga analytiska metoder är därför väsentlig för en korrekt diagnostik och behandling av infektionen. Syftet med studien var att ge en översikt av icke-invasiva metoder som tillämpas för påvisning av H. pylori och utvärdera vilken metod som är bäst lämpad, med avseende på metodens prestandaegenskaper och det kliniska tillståndet hos patienten. En systematisk litteraturöversikt utfördes, genom sökning efter vetenskapliga artiklar med inklusions- och exklusionskriterier i databaserna PubMed och CINAHL. Utvalda artiklar kvalitetsgranskades och 20 studier inkluderades i resultatet. Sammanställt hade fecesantigentester en sensitivitet och specificitet på 92,64% respektive 91,47%, antikroppstester hade 97,20% respektive 81,59%, urea utandningstester hade 91,40% respektive 91,70% och polymeraskedjereaktionen hade 75,45% respektive 98,30%. Därutöver hade kliniska tillstånd såsom atrofisk gastrit, intestinal metaplasi och gastrointestinal blödning en negativ påverkan på metodernas diagnostiska tillförlitlighet. Studien konstaterade att beträffande metodens prestanda är fecesantigentester mest lämpliga för påvisning av H. pylori- infektion. Vid allvarligare kliniska åkommor bör minst två icke-invasiva diagnostiska metoder tillämpas för att säkerställa pålitliga resultat. / Helicobacter pylori infection is one of the leading causes of ventricular pathologies. Reliable analytic methods are therefore crucial for the correct diagnosis and treatment of the infection. The aim of this study was to provide an overview of non-invasive diagnostic methods used for the detection of H. pylori and to evaluate which method is most suitable, considering its performance and the clinical condition of the patient. A systematic literature review was conducted, searching peer-reviewed research articles with inclusion and exclusion criteria on the databases PubMed and CINAHL. An assessment of the selected articles quality resulted in the inclusion of 20 articles. Overall, stool antigen tests had a sensitivity and specificity of 92,64% and 91,47% respectively, antibody tests 97,20% and 81,59% respectively, urea breath tests 91,40% and 91,70% respectively, and the polymerase chain reaction 75,45% and 98,30% respectively. Furthermore, conditions such as atrophic gastritis, intestinal metaplasia and gastrointestinal bleeding had a negative impact on the diagnostic accuracy of the methods. This study concluded that, regarding the methods performance, stool antigen tests are more suitable for detecting a H. pylori infection. With the mentioned clinical conditions, at least two non- invasive diagnostic methods should be used to ensure reliable results.

This diploma thesis deals with laboratory functional diagnostics of malabsorption syndromes. Especially the functional diagnosis of lactose intolerance. The golden standard for the functional diagnosis of lactose intolerance is the breath test. The aim of the study was to determine the prevalence of lactose intolerance (LI) using a lactose breath test when consuming a dose of 20 g of lactose in patients with gastrointestinal symptoms and in volunteers who do not show gastrointestinal problems. Part of the research was also to examine the symptoms that led the individual to see a doctor and undergo a lactose breath test. The method consisted in the evaluation of the results of breath tests, which were performed on patients and volunteers in the gastroenterological laboratory of the 1st Medical Faculty of Charles University and the General Hospital. A questionnaire was given to everyone to evaluate the symptoms of LI and the phenomena leading to malabsorption. Lactose intolerance was confirmed in 92 % of patients and 79 % of volunteers. The most reported symptoms in the patient sample were typical gastrointestinal LI-related problems: gastric and intestinal problems after milk consumption (85 % of patients), gastric and intestinal problems after consumption of dairy products (85 % of patients),...

No description available.

.La consommation journalière de fructose est en augmentation croissante, jusqu'à plus de 50g par jour aux Etats-Unis et en Europe de l'Ouest. Le fructose est de plus en plus incorporé dans les boissons, les produits laitiers et les conserves, les produits cuisinés ou transformés. Le fructose peut déclencher ou aggraver les symptômes digestifs chez des volontaires sains, mais aussi dans le syndrome de l'intestin irritable. Le rôle de l'hypersensibilité viscérale dans le déclenchement des symptômes, lié à la prise de fructose a été suspecté mais n'a jamais été évalué. La prévalence de la malabsorption du fructose était mal documentée chez les patients souffrant d'un syndrome de l'intestin irritable, principalement en raison de l'hétérogénéité des méthodes diagnostiques. Le premier objectif de ce travail a été de définir, dans une population de patients souffrant d'un syndrome de l'intestin irritable, la prévalence de la malabsorption du fructose. Notre test de malabsorption du fructose a été défini par une dose de charge de 25g. Chez nos patients souffrant d'un syndrome de l'intestin irritable, 22% présentaient une malabsorption du fructose. Les patients jeunes et de sexe masculin étaient plus à risque de malabsorption du fructose. Nous avons également étudié l'association de la malabsorption du fructose avec d'autres anomalies physiopathologiques connues dans le syndrome de l'intestin irritable. Nous n'avons pas retrouvé d'association entre la présence d'une inflammation digestive et la présence ou non d'une malabsorption du fructose. En revanche, une association a été retrouvée entre malabsorption du fructose et hypersensibilité viscérale. L'efficacité du régime appauvri en fructose dans le syndrome de l'intestin irritable est connue. L'existence ou non d'une malabsorption du fructose associée pourrait être un facteur prédictif d'efficacité d'un tel régime. Le deuxième objectif de ce travail a été de déterminer si le test de dépistage de la malabsorption au fructose permettait de prédire l'efficacité du régime appauvri en fructose sur les symptômes digestifs des patients souffrant d'un syndrome de l'intestin irritable. Les résultats de notre étude ont confirmé l'efficacité du régime appauvri en fructose dans le syndrome de l'intestin irritable. En revanche, la présence ou non d'un test respiratoire au fructose positif n'impactait pas l'efficacité du régime. Le dernier objectif de ce travail était de modéliser la malabsorption du fructose sur des modèles murins, pour permettre d'identifier les mécanismes physiopathologiques sous-jacents. La modélisation sur 3 modèles murins de malabsorption du fructose (par régime riche en fructose, par délétion des gènes codant les transporteurs du fructose GLUT5 et GUT2) permettait d'induire une hypersensibilité viscérale associée à une augmentation de la perméabilité intestinale, deux anomalies déjà rapportées dans le syndrome de l'intestin irritable. L'étude des mécanismes physiopathologiques sous-jacents a permis d'écarter l'implication d'une inflammation de bas grade qui n'était pas retrouvée chez nos souris. L'augmentation d'activité élastase dans les selles de souris avec malabsorption du fructose était associée à l'hypersensibilité viscérale. Or il a déjà été démontré que l'activité protéasique pouvait être responsable d'une hypersensibilité viscérale et d'une augmentation de la perméabilité intestinale. Les récepteurs associés à la protéase-2 sont connus pour être associés à l'hypersensibilité viscérale et l'augmentation de la perméabilité intestinale. Les résultats obtenus dans le cadre de ce travail soulignent le rôle de la malabsorption du fructose, qui entraine la survenue d'une hypersensibilité viscérale et d'une augmentation de la perméabilité intestinale, dans le syndrome de l'intestin irritable. Un régime appauvri en fructose n'améliore pas de manière ciblée les symptômes des patients souffrant d'un syndrome de l'intestin irritable avec malabsorption du fructose. / Fructose intake has increased by up to 50 g per day in the USA and Western Europe. Fructose is increasingly incorporated in beverages, dairy products and canned, baked or processed foods worldwide. Fructose has been shown to trigger or worsen digestive symptoms not only in healthy volunteers, but also in patients with irritable bowel syndrome. The involvement of visceral hypersensitivity has been suspected but has never been assessed. The prevalence of fructose malabsorption in patients with irritable bowel syndrome in Western Europe remains poorly documented, due to the heterogeneity of available tests. Therefore, the first objective of this present work was to assess the prevalence of fructose malabsorption in patients with irritable bowel syndrome. We assessed fructose malabsorption with a fructose breath test, after a 25 g load. We systematically ruled out small intestinal bacterial overgrowth which could promote false positive. In our irritable bowel syndrome patients, 22% had fructose malabsorption. Young, male patients were more likely to have fructose malabsorption. We also assessed the association between fructose malabsorption and other abnormalities. We did not observe any association between low-grade inflammation (with faecal calprotectin dosage) or fructose malabsorption. In contrast, an association between fructose malabsorption and visceral hypersensitivity was evidenced. Low fructose diet is known to improve symptoms in patients with irritable bowel syndrome. The presence of fructose malabsorption could be predictive of the efficacy of a low fructose diet. The second objective of this work was to determine if an abnormal fructose breath test was a predictor of symptomatic response to low fructose diet in irritable bowel syndrome. Our study has confirmed the efficacy of low fructose diet on irritable bowel syndrome. However, the results of the fructose breath test had no impact on its efficacy. One explanation for this result could be the presence of other abnormalities (including visceral hypersensitivity) that were not addressed only with a diet. The last objective of this work was to model fructose malabsorption in mice, in order to identify the underlying mechanisms. We used three models of fructose malabsorption (high fructose diet, invalidation of GLUT5 and GLUT2 coding gene). In these models, fructose malabsorption induced visceral hypersensitivity and increased intestinal permeability, the two abnormalities being reported in irritable bowel syndrome. In our models, there was no low-grade inflammation. Increased elastase activity in mice faeces was associated with visceral hypersensitivity. Protease-activated receptor-2 is known to be associated with visceral hypersensitivity and increases intestinal permeability. Further works are warranted to determine the involvement of protease-activated receptor-2 in fructose malabsorption-associated visceral hypersensitivity. The results of this work underlined the role of fructose malabsorption in irritable bowel syndrome, in the onset of visceral hypersensitivity and increased intestinal permeability. A low fructose diet is not helpful to improve symptoms of irritable bowel syndrome with fructose malabsorption.