AIM:To evaluate the performance of commercially available immunochromatographic (ICT) and immunoblot tests covering the current infection marker CIM and conventional ELISA for the diagnosis of H pylori infection in ad...AIM:To evaluate the performance of commercially available immunochromatographic (ICT) and immunoblot tests covering the current infection marker CIM and conventional ELISA for the diagnosis of H pylori infection in adult dyspeptic patients. METHODS:Consecutive non-treated dyspeptic patients undergoing diagnostic endoscopy were tested for H pylori infection by culture, rapid urease test, and histology of gastric biopsy specimens. Serum from 61 H pylori infected and 21 non-infected patients were tested for anti-H pylori IgG antibodies by commercial ELISA (AccuBindTM ELISA, Monobind, USA), ICT (Assure H pylori Rapid Test, Genelabs Diagnostics, Singapore), and immunoblot (Helico Blot 2.1, Genelabs Diagnostics, Singapore) assays. ICT and immunoblot kits cover CIM among other parameters and their performance with and without CIM was evaluated separately. RESULTS:Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of ELISA were 96.7%, 42.8%, 83.1%, 81.8%, and 82.9%, of ICT were 90.1%, 80.9%, 93.2%, 73.9%, and 87.8%, of ICT with CIM were 88.5%, 90.4%, 96.4%, 73.0%, and 89.0%, of immunoblot were 98.3%, 80.9%, 93.7%, 94.4%, and 93.9%, and of immunoblot with CIM were 98.3%, 90.4%, 96.7%, 95.0%, and 96.3%, respectively. CONCLUSION:Immunoblot with CIM had the best performance. ICT with CIM was found to be more specific and accurate than the conventional ELISA and may be useful for non-invasive diagnosis of H pylori infection.展开更多
Purpose: Irritable bowel syndrome (IBS) and gastrointestinal (GI) disorders are genuine health problems that have serious consequences on a patient’s quality of life (QoL). IBS is a functional disorder characterized ...Purpose: Irritable bowel syndrome (IBS) and gastrointestinal (GI) disorders are genuine health problems that have serious consequences on a patient’s quality of life (QoL). IBS is a functional disorder characterized by chronically recurring symptoms, including abdominal pain or discomfort, altered stool frequency and consistency, and abdominal bloating in the absence of structural or biochemical abnormalities. Studies have indicated that symptoms and disability related to IBS and GI disorders correlate with QoL measures. Additionally, those who respond to therapy have an improvement in QoL. Therefore, we explored an open trial of a food elimination diet guided by the ImmunoBloodprint food sensitivity test and its effect on QoL in patients self-reporting an unresolved GI disorder. Methods: Eighty-four subjects aged 18 and above participated in the study. Subjects eliminated all IgG-mediated reactive foods from their diet for 90 days. QoL was assessed with the Irritable Bowel Syndrome-36 (IBS-36) and the Medical Outcomes Study Short Form-36 (SF-36) at baseline and 30-, 60-, and 90-day follow-up. The data were analyzed with linear mixed models. Results: Subjects had statistically significant improvements in all indicators of QoL according to the IBS-36 and SF-36 from baseline to 90- day follow-up. Conclusions: Subjects with unresolved self-reported GI disorders were able to improve all indicators of QoL in response to eliminating IgG- reactive foods from the diet. Given the inconvenience of keeping track of foods and symptoms to eliminate intolerant foods, a food sensitivity test combined with an elimination diet may be an effective method for improving subjective markers of QoL and health.展开更多
Lactose breath test (LBT) is considered the gold standard for the diagnosis of lactose malabsorption. The test is considered positive for a peak of hydrogen (H2) ≥ 20 parts per million (ppm) above the baseline. Some ...Lactose breath test (LBT) is considered the gold standard for the diagnosis of lactose malabsorption. The test is considered positive for a peak of hydrogen (H2) ≥ 20 parts per million (ppm) above the baseline. Some patients (pts) showed a rapid peak between 30 and 90 minutes after lactose ingestion. The aim of this study was to evaluate the predictive value of an early peak during a LBT and an accelerated oro-cecal transit time (OCTT). We retrospectively analyzed all pts who referred to our Gastroenterology unit for Irritable Bowel Syndrome, from January to September 2012, who performed LBT, glucose and lactulose breath test. We consider a positive LBT for a peak of H2 > 20 ppm, a positive GHBT for a peak >12 ppm and we considered a normal OCCT a peak of H2 ≥ 10 ppm between 75 ± 105 min after lactulose load. The correlation between LBT and OCTT was evaluated by Pearson score. 93 pts (65 F/28 M mean age 47 ± 6 years) with a positive LBT, without small intestinal bacterial overgrowth were analyzed: 46 pts (32 F/14 M;mean age 48 ± 6 years) with an early peak (2 (≥20 ppm) were enrolled as case, and 47 pts matched for sex and age with a peak of H2 after 90 min were enrolled as controls. 72% (33/46) of the group with an early peak showed an accelerated, 17% (8/46) a normal and 11% (5/46) a delayed OCTT. Meanwhile, in control group 40.4% (19/47) showed a normal, 57.5% (27/47) a delayed and just 1 pts an accelerated OCTT. The specificity and sensibility of LBT for an accelerated OCTT were 97.9% and 71.7% respectively. The positive predictive value of LBT for an accelerated OCTT is 97.1%;the negative predictive value is 78%. There is a significant correlation between LBT and OCTT (p The presence of an early peak of H2 between 30 and 90 min after the ingestion of 25 gr of lactose could predict the presence of an accelerated OCTT in 97% of pts. If confirmed by further study, in this subset of pts, lactulose breath test for evaluating OCTT could be avoided.展开更多
目的探讨结核感染T细胞斑点试验(enzyme-linked immunospot assay in detection of mycobacterium tuberculosis infection,T-SPOT.TB)在临床诊断结核性腹膜炎中的应用价值。方法对临床明确诊断结核性腹膜炎及可疑结核性腹膜炎患者(n=37...目的探讨结核感染T细胞斑点试验(enzyme-linked immunospot assay in detection of mycobacterium tuberculosis infection,T-SPOT.TB)在临床诊断结核性腹膜炎中的应用价值。方法对临床明确诊断结核性腹膜炎及可疑结核性腹膜炎患者(n=37)同时实施T-SPOT.TB、结核菌素试验(PPD)、结核抗体、血清腺苷脱胺酶(ADA)等检测,同时设非结核性腹膜炎患者为对照组(n=25)。结果利用T-SPOT.TB试验诊断结核性腹膜炎的阳性率为97.3%(36/37),明显高于PPD的45.5%(15/33)、结核抗体检查的15.2%(5/33)、血清ADA的33.3%(7/21),差异有统计学意义(P<0.01)。T-SPOT.TB试验诊断结核性腹膜炎的敏感性和特异性分别为97.3%和92.0%,显著高于PPD的45.5%和61.9%,差异有统计学意义(P<0.01)。结论 T-SPOT.TB酶联免疫斑点法是一种具有较高敏感性和特异性的检测结核感染的技术,对快速而准确地诊断结核性腹膜炎具有重要的临床应用价值。展开更多
文摘AIM:To evaluate the performance of commercially available immunochromatographic (ICT) and immunoblot tests covering the current infection marker CIM and conventional ELISA for the diagnosis of H pylori infection in adult dyspeptic patients. METHODS:Consecutive non-treated dyspeptic patients undergoing diagnostic endoscopy were tested for H pylori infection by culture, rapid urease test, and histology of gastric biopsy specimens. Serum from 61 H pylori infected and 21 non-infected patients were tested for anti-H pylori IgG antibodies by commercial ELISA (AccuBindTM ELISA, Monobind, USA), ICT (Assure H pylori Rapid Test, Genelabs Diagnostics, Singapore), and immunoblot (Helico Blot 2.1, Genelabs Diagnostics, Singapore) assays. ICT and immunoblot kits cover CIM among other parameters and their performance with and without CIM was evaluated separately. RESULTS:Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of ELISA were 96.7%, 42.8%, 83.1%, 81.8%, and 82.9%, of ICT were 90.1%, 80.9%, 93.2%, 73.9%, and 87.8%, of ICT with CIM were 88.5%, 90.4%, 96.4%, 73.0%, and 89.0%, of immunoblot were 98.3%, 80.9%, 93.7%, 94.4%, and 93.9%, and of immunoblot with CIM were 98.3%, 90.4%, 96.7%, 95.0%, and 96.3%, respectively. CONCLUSION:Immunoblot with CIM had the best performance. ICT with CIM was found to be more specific and accurate than the conventional ELISA and may be useful for non-invasive diagnosis of H pylori infection.
文摘Purpose: Irritable bowel syndrome (IBS) and gastrointestinal (GI) disorders are genuine health problems that have serious consequences on a patient’s quality of life (QoL). IBS is a functional disorder characterized by chronically recurring symptoms, including abdominal pain or discomfort, altered stool frequency and consistency, and abdominal bloating in the absence of structural or biochemical abnormalities. Studies have indicated that symptoms and disability related to IBS and GI disorders correlate with QoL measures. Additionally, those who respond to therapy have an improvement in QoL. Therefore, we explored an open trial of a food elimination diet guided by the ImmunoBloodprint food sensitivity test and its effect on QoL in patients self-reporting an unresolved GI disorder. Methods: Eighty-four subjects aged 18 and above participated in the study. Subjects eliminated all IgG-mediated reactive foods from their diet for 90 days. QoL was assessed with the Irritable Bowel Syndrome-36 (IBS-36) and the Medical Outcomes Study Short Form-36 (SF-36) at baseline and 30-, 60-, and 90-day follow-up. The data were analyzed with linear mixed models. Results: Subjects had statistically significant improvements in all indicators of QoL according to the IBS-36 and SF-36 from baseline to 90- day follow-up. Conclusions: Subjects with unresolved self-reported GI disorders were able to improve all indicators of QoL in response to eliminating IgG- reactive foods from the diet. Given the inconvenience of keeping track of foods and symptoms to eliminate intolerant foods, a food sensitivity test combined with an elimination diet may be an effective method for improving subjective markers of QoL and health.
文摘Lactose breath test (LBT) is considered the gold standard for the diagnosis of lactose malabsorption. The test is considered positive for a peak of hydrogen (H2) ≥ 20 parts per million (ppm) above the baseline. Some patients (pts) showed a rapid peak between 30 and 90 minutes after lactose ingestion. The aim of this study was to evaluate the predictive value of an early peak during a LBT and an accelerated oro-cecal transit time (OCTT). We retrospectively analyzed all pts who referred to our Gastroenterology unit for Irritable Bowel Syndrome, from January to September 2012, who performed LBT, glucose and lactulose breath test. We consider a positive LBT for a peak of H2 > 20 ppm, a positive GHBT for a peak >12 ppm and we considered a normal OCCT a peak of H2 ≥ 10 ppm between 75 ± 105 min after lactulose load. The correlation between LBT and OCTT was evaluated by Pearson score. 93 pts (65 F/28 M mean age 47 ± 6 years) with a positive LBT, without small intestinal bacterial overgrowth were analyzed: 46 pts (32 F/14 M;mean age 48 ± 6 years) with an early peak (2 (≥20 ppm) were enrolled as case, and 47 pts matched for sex and age with a peak of H2 after 90 min were enrolled as controls. 72% (33/46) of the group with an early peak showed an accelerated, 17% (8/46) a normal and 11% (5/46) a delayed OCTT. Meanwhile, in control group 40.4% (19/47) showed a normal, 57.5% (27/47) a delayed and just 1 pts an accelerated OCTT. The specificity and sensibility of LBT for an accelerated OCTT were 97.9% and 71.7% respectively. The positive predictive value of LBT for an accelerated OCTT is 97.1%;the negative predictive value is 78%. There is a significant correlation between LBT and OCTT (p The presence of an early peak of H2 between 30 and 90 min after the ingestion of 25 gr of lactose could predict the presence of an accelerated OCTT in 97% of pts. If confirmed by further study, in this subset of pts, lactulose breath test for evaluating OCTT could be avoided.
文摘目的探讨结核感染T细胞斑点试验(enzyme-linked immunospot assay in detection of mycobacterium tuberculosis infection,T-SPOT.TB)在临床诊断结核性腹膜炎中的应用价值。方法对临床明确诊断结核性腹膜炎及可疑结核性腹膜炎患者(n=37)同时实施T-SPOT.TB、结核菌素试验(PPD)、结核抗体、血清腺苷脱胺酶(ADA)等检测,同时设非结核性腹膜炎患者为对照组(n=25)。结果利用T-SPOT.TB试验诊断结核性腹膜炎的阳性率为97.3%(36/37),明显高于PPD的45.5%(15/33)、结核抗体检查的15.2%(5/33)、血清ADA的33.3%(7/21),差异有统计学意义(P<0.01)。T-SPOT.TB试验诊断结核性腹膜炎的敏感性和特异性分别为97.3%和92.0%,显著高于PPD的45.5%和61.9%,差异有统计学意义(P<0.01)。结论 T-SPOT.TB酶联免疫斑点法是一种具有较高敏感性和特异性的检测结核感染的技术,对快速而准确地诊断结核性腹膜炎具有重要的临床应用价值。
