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Helicobacter pylori Noninvasive Testing

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61. Guidelines for the Primary Prevention of Stroke: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association

among individuals who have not previously experienced a stroke or transient ischemic attack. Evidence- based recommendations are included for the control of risk factors, interventional approaches to atherosclerotic disease of the cervicocephalic circulation, and antithrombotic treatments for preventing thrombotic and thromboembolic stroke. Further recommendations are provided for genetic and pharmacogenetic testing and for the prevention of stroke in a variety of other specific circumstances (...) for primary stroke prevention. 14,15 Some of the goals of such risk assessment tools are to identify people at elevated risk who might be unaware of their risk, to assess risk in the presence of >1 condition, to measure an individual’s risk that can be tracked and lowered by appropri- ate modifications, to estimate risk for selecting treatments or stratification in clinical trials, and to guide appropriate use of further diagnostic testing. Although stroke risk assessment tools exist, the complexi- ties

2014 American Heart Association

62. Guidelines on Genetic Evaluation and Management of Lynch Syndrome: A Consensus Statement by the US Multi-Society Task Force on Colorectal Cancer 2

; GRADE, Grades of Recommendation, Assessment, Development, and Evaluation. The American Journal of GASTROENTEROLOGY VOLUME 104 | XXX 2014 www.amjgastro.com 14 Giardiello et al. patients appear to be histologically classifi ed as intestinal type ( 45,47 ) and, consequently, potentially amenable to endoscopic surveillance. Data on screening for gastric cancer are lacking. However, Renkonen-Sinisalo et al. ( 149 ) reported that precursor lesions for gastrointestinal cancer, including Helicobacter pylori (...) then, germline testing with increasing sensitivity has been available for patients, as additional genetic discoveries have occurred. When used appropriately, genetic testing for LS can confi rm the diagnosis at the molecular level, justify surveillance of at-risk persons, decrease the cost of surveillance by risk strati- fi cation, aid in surgical and chemoprevention management, and help in decisions concerning family and career planning. How- ever, when used inappropriately, genetic testing can misinform

2014 American College of Gastroenterology

63. Genetics of Colorectal Cancer (PDQ®): Health Professional Version

and MMRpredict are recommended for genetic evaluation referral and testing. Associated Genes and Syndromes Hereditary CRC has two well-described forms: (1) polyposis (including and (AFAP), which are caused by pathogenic variants in the gene; and , which is caused by pathogenic variants in the MUTYH gene); and (2) (often referred to as hereditary nonpolyposis colorectal cancer), which is caused by germline pathogenic variants in DNA MMR genes ( , , , and ) and . Other CRC syndromes and their associated genes (...) with newly diagnosed CRC are evaluated for Lynch syndrome through molecular diagnostic tumor testing assessing MMR deficiency. A is supported, in which all CRC cases are evaluated regardless of age at diagnosis or fulfillment of existing clinical criteria for Lynch syndrome. A more cost-effective approach has been reported whereby all patients aged 70 years or younger with CRC and older patients who meet the revised Bethesda guidelines are tested for Lynch syndrome. Tumor evaluation often begins

2016 PDQ - NCI's Comprehensive Cancer Database

64. MKSAP: 35-year-old man with upper abdominal discomfort

. The most appropriate management is noninvasive Helicobacter pylori testing, followed by eradication therapy if test results are positive. Noninvasive H. pylori testing modalities include serology, the fecal antigen test, or the urea breath test. The recommended and most cost-effective approach for this patient is serologic testing. He is younger than 50 years of age with vague abdominal discomfort without alarm features (anemia; dysphagia; odynophagia; vomiting; weight loss; family history of upper (...) treatment or PPI therapy. Patients older than 50 years or with alarm features should be evaluated with upper endoscopy. In patients without alarm features, endoscopy as an initial management intervention would be unlikely to find gastritis, peptic ulcer disease, or esophagitis. Key Point Before pursuing Helicobacter pylori eradication therapy, noninvasive testing for H. pylori should be performed to confirm infection. This content is excerpted from with permission from the (ACP). Use is restricted

2017 KevinMD blog

65. NASPGHAN Guidelines for Training in Pediatric Gastroenterology

care dollars and strive for continuous quality enhancement of care. Knowledge of the dollar footprint of care will be imperative, especially as the subspecialist will have increasing access to an ever-expanding array of technological tools and diagnostic modalities, including medical genetic and pharmacogenetic testing. Furthermore, it is likely that as medical homes are established, pediatric subspecialists will need to develop new relationships with primary care providers. The other trend (...) biopsy, rectal biopsy, manometry (esophageal, antroduodenal, colonic and anorectal), esophageal pH and impe- dance monitoring, and breath test analysis. Since the publication of the 1999 North American Society for Pediatric Gastroenterology and Nutrition training guidelines (1), the 2009 ACGME update has moved several procedures from the ‘‘demonstrate competence’’ list to the ‘‘understand the principles’’ list, including paracentesis and percutaneous liver biopsy (7). This change was driven

2013 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition

66. Clinical Practice Guidelines for the Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Patient

appearance and/ or liver function tests (Grade D). r24(39)-r. Routine screening for the presence of Helicobacter pylori before bariatric surgery may be con- sidered in high-prevalence areas (Grade C; beL 3). r25(40)-r. Before bariatric surgery, prophylactic treat - ment for gouty attacks should be considered in patients with a history of gout (Grade C, beL 3). r26(41). There are insufficient data to warrant pre- operative assessment of bone mineral density with dual- energy x-ray absorptiometry (DXA (...) folate, homocysteine, methylmalonic acid optional), and 25-vitamin D (vitamins A and E optional); consider more extensive testing in patients undergoing malabsorptive procedures based on symptoms and risks ü Cardiopulmonary evaluation with sleep apnea screening (ECG, CXR, echocardiography if cardiac disease or pulmonary hypertension suspected; DVT evaluation if clinically indicated) ü GI evaluation (H pylori screening in high-prevalence areas; gallbladder evaluation and upper endoscopy if clinically

2013 American Association of Clinical Endocrinologists

67. Periodontal Disease and Atherosclerotic Vascular Disease: Does the Evidence Support an Independent Association?

Veillonella species Gram-negative bacilli Aggregatibacter (formerly Actinobacillus ) actinomycetemcomitans Capnocytophaga species Eikenella corrodens Helicobacter pylori Chlamydophila pneumoniae Porphyromonas gingivalis Fusobacterium nucleatum Prevotella intermedia Tannerella forsythia Selenomonas noxia Campylobacter rectu s Spirochetes Treponema denticola Other Treponema species Methanogenic archaea Methanobrevibacter oralis -like Sulfate-reducing bacteria and archaea Desulfomicrobium orale Desulfovibrio (...) -positive to an increased number of obligate anaerobic gram-negative organisms, such as Porphyromonas gingivalis , Tannerella forsythia , Treponema denticola , and Selenomonas noxia , as well as Campylobacter rectus , Aggregatibacter (formerly Actinobacillus ) actinomycetemcomitans , and Prevotella intermedia , and spirochetes. Other microorganisms found in PD include Chlamydophila pneumoniae ; Mycoplasma , ; Helicobacter pylori ; candida ; Epstein-Barr virus, cytomegalovirus, and herpesviruses ; ameba

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2012 American Heart Association

68. Percutaneous Coronary Intervention: Guideline For

of CABG or PCI to improve survival is uncertain in patients with previous CABG and extensive anterior wall ischemia on noninvasive testing (85–93). (Level of Evidence: B) CLASS III: HARM 1. CABGorPCIshouldnotbeperformedwiththeprimaryorsoleintent to improve survival in patients with SIHD with 1 or more coronary stenoses that are not anatomically or functionally signi?cant (e.g., 70%diameternon–leftmaincoronaryarterystenosis,FFR0.80, no or only mild ischemia on noninvasive testing), involve only (...) Closure Devices: Recommendations...e84 6. Postprocedural Considerations e84 6.1. Postprocedural Antiplatelet Therapy: Recommendations e84 6.1.1. PPIs and Antiplatelet Therapy: Recommendations e86 6.1.2. Clopidogrel Genetic Testing: Recommendations e86 6.1.3. Platelet Function Testing: Recommendations e86 6.2. Stent Thrombosis e87 6.3. Restenosis: Recommendations e87 6.3.1. Background and Incidence e87 6.3.2. Restenosis After Balloon Angioplasty e88 6.3.3. Restenosis After BMS e88 6.3.4. Restenosis

2011 American College of Cardiology

69. 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention

involvement of the proximal LAD artery) or 1-vessel proximal LAD disease. , , , (Level of Evidence: B) CABG might be considered with the primary or sole intent of improving survival in patients with SIHD with severe LV systolic dysfunction (EF <35%) whether or not viable myocardium is present. , , , (Level of Evidence: B) The usefulness of CABG or PCI to improve survival is uncertain in patients with previous CABG and extensive anterior wall ischemia on noninvasive testing. (Level of Evidence: B) Class (...) III: HARM CABG or PCI should not be performed with the primary or sole intent to improve survival in patients with SIHD with 1 or more coronary stenoses that are not anatomically or functionally significant (eg, <70% diameter non–left main coronary artery stenosis, FFR >0.80, no or only mild ischemia on noninvasive testing), involve only the left circumflex or right coronary artery, or subtend only a small area of viable myocardium. , , , , (Level of Evidence: B) 2.3. Revascularization to Improve

2011 American Heart Association

70. 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: Executive Summary

with the primary or sole intent of improving survival in patients with SIHD with severe left ventricular systolic dysfunction (ejection fraction <35%) whether or not viable myocardium is present. , , , (Level of Evidence: B) The usefulness of CABG or PCI to improve survival is uncertain in patients with previous CABG and extensive anterior wall ischemia on noninvasive testing. (Level of Evidence: B) Class III: HARM CABG or PCI should not be performed with the primary or sole intent to improve survival (...) in patients with SIHD with 1 or more coronary stenoses that are not anatomically or functionally significant (eg, <70% diameter non–left main coronary artery stenosis, fractional flow reserve >0.80, no or only mild ischemia on noninvasive testing), involve only the left circumflex or right coronary artery, or subtend only a small area of viable myocardium. , , , , (Level of Evidence: B) 2.3. Revascularization to Improve Symptoms Class I CABG or PCI to improve symptoms is beneficial in patients with 1

2011 American Heart Association

71. A Phase 1b Open-Label Study Investigating the Safety and Pharmacokinetics of Administration of Subcutaneous Blinatumomab for the Treatment of Relapsed/Refractory Indolent Non-Hodgkin's Lymphoma

. Follicular Lymphoma I, II, IIIA Marginal zone lymphoma (extranodal, nodal or splenic). Subjects with gastric mucosa-associated lymphoid tissue must have progressed after Helicobacter pylori therapy and radiation. Subjects with splenic marginal zone lymphoma must have prior splenectomy. Lymphoplasmocytic lymphoma Mantle cell lymphoma ([MCL] with the exception of aggressive MCL, defined as Ki67 > 30%, or blastoid histology) Small lymphocytic lymphoma Disease status must be 1 of the following: Primary (...) : • To evaluate the safety and tolerability of subcutaneous (SC) blinatumomab dose administrations Secondary Objectives: To determine pharmacokinetics (PK) with continuous intravenous (cIV) and SC administrations To estimate the maximum tolerated dose (MTD) tested for blinatumomab administered subcutaneously To determine the incidence of anti-blinatumomab antibody formation following SC administration To evaluate efficacy response following treatment with SC blinatumomab administration Exploratory Objective

2016 Clinical Trials

73. Care of the Patient with Ocular Surface Disorders

: postmenopausal women, patients with Helicobacter pylori, older people, computer users, and long-term contact lens wearers. 63-65 True mucin deficiency is rare; one report estimates the prevalence of OCP to be 1 in 20,000 persons. 66 Cicatricial pemphigoid is the most common of the immunobullous disorders causing conjunctival cicatrization secondary to destruction of goblet cells. The disease is usually bilateral and more common in females, with most cases occurring between 30 and 90 years of age, but most (...) population may be greater than that of Caucasian populations. 5 It has been estimated that 5 million Americans over the age of 50 years have dry eye, 2 and 25% of the US population reports or suffers from dry eyes or some abnormality of the exposed ocular surface. 6,7 Because there are many undiagnosed cases, due to situational or environmental contributors, the actual number is probably much greater. A complete group of tests for ocular surface disorders has been reported by the Dye Eye WorkShop (DEWS

2010 American Optometric Association

74. Gastric Activity and Gastrointestinal Peptides in Patients With Functional Dyspepsia

: postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS). Disorders of gastric electric activity and abnormal gastric emptying are probably actively involved in the FD onset. Different noninvasive procedures may be applied in order to evaluate the gastric motor functions such as 13C breath testing and cutaneous electrogastrography. Besides, different gastrointestinal peptides (i.e. CCK, peptide YY, Neurotensin, Somatostatin, Leptin, Ghrelin, Motilin, Gastrin, Pepsinogen I and II (...) ) are involved in the control of gastroduodenal motility. Aims of the present study are: 1) to evaluate the GI peptide circulating concentrations, the gastric electrical activity and gastric emptying time by applying noninvasive procedures in patients suffering from functional dyspepsia and 2) to test whether a significant difference exists between the two diagnostic categories of meal-induced dyspeptic symptoms Condition or disease Dyspepsia Detailed Description: Functional dyspepsia is one of the most

2014 Clinical Trials

75. Genetics of Colorectal Cancer

carries a pathogenic variant in a mismatch repair (MMR) gene associated with Lynch syndrome, the most common inherited CRC syndrome. These include the MMRpro, MMRpredict, and PREMM5 (PREdiction Model for gene Mutations) prediction models. Individuals with a quantified risk of 2.5% or greater on PREMM5 or 5% or greater on MMRpro and MMRpredict are recommended for genetic evaluation referral and testing. Associated Genes and Syndromes Hereditary CRC has two well-described forms: (1) polyposis (including (...) variant associated with an inherited cancer syndrome. are showing promise in identifying common, low-penetrance susceptibility alleles for many complex diseases, including CRCs, but the clinical utility of these findings remains uncertain. Clinical Management It is becoming the standard of care at many centers that all individuals with newly diagnosed CRC are evaluated for Lynch syndrome through molecular diagnostic tumor testing assessing MMR deficiency. A is supported, in which all CRC cases

2012 PDQ - NCI's Comprehensive Cancer Database

76. Peptic Ulcer Disease (Overview)

patients with uncomplicated PUD, routine laboratory tests usually are not helpful; instead, documentation of PUD depends on radiographic and endoscopic confirmation. Testing for H pylori infection is essential in all patients with peptic ulcers. Rapid urease tests are considered the endoscopic diagnostic test of choice. Of the noninvasive tests, fecal antigen testing is more accurate than antibody testing and is less expensive than urea breath tests but either is reasonable. A fasting serum gastrin (...) in individual cases but is not needed routinely. For patient education resources, see as well as , , and . Previous References [Guideline] Chey WD, Wong BC. American College of Gastroenterology guideline on the management of Helicobacter pylori infection. Am J Gastroenterol . 2007 Aug. 102(8):1808-25. . Javid G, Zargar SA, U-Saif R, et al. Comparison of p.o. or i.v. proton pump inhibitors on 72-h intragastric pH in bleeding peptic ulcer. J Gastroenterol Hepatol . 2009 Jul. 24(7):1236-43. . Lai KC, Lam SK

2014 eMedicine.com

77. Coronary Artery Atherosclerosis (Follow-up)

and Forrester Chest Pain Prediction Rule: For example, in patients with suspected CAD using the new criteria, if the PTP is < 15%, investigate other possible causes and consider a diagnosis of functional coronary disease; if the PTP is intermediate (eg, 15%-85%), send the patient for noninvasive testing; if the PTP is high (eg, >85%), a diagnosis of CAD is established, and patient risk stratification should follow In stable CAD, the functional impact of coronary lesions relative to their angiographic (...) to less than 70 mg/dL did not lead to further improvement in graft patency. [ ] Statin therapy is also safe and can improve liver tests while reducing cardiovascular morbidity in patients with mild- to moderately-abnormal liver test results that may be attributable to nonalcoholic fatty liver disease. [ ] In the United States, the most commonly used guidelines for cholesterol management are those from the NCEP Adult Treatment Panel (ATP). In high-risk persons, the recommended LDL-C goal is less than

2014 eMedicine.com

78. Coronary Artery Atherosclerosis (Diagnosis)

Stable angina pectoris Intermittent claudication Mesenteric angina Tachycardia: Common in persons with acute coronary syndrome (ACS) and acute myocardial infarction (AMI) High or low blood pressure S 4 gallop: A common early finding S 3 gallop: An indication of reduced left ventricular function Heart murmurs Tachypnea Xanthelasmas Livedo reticularis Syncope Leg edema Rales See for more detail. Diagnosis Laboratory tests: Complete blood count (CBC) Chemistry panel Lipid profile Thyroid function tests (...) comorbidities than test subjects. The guideline is now “effectiveness-based” rather than “evidence-based.” Effectiveness-based considerations have reduced the strength of previous recommendations for use of aspirin, statins (in women with elevated C-reactive protein but normal cholesterol), and aggressive glycemic control in diabetes. The elderly and coronary artery disease Age is the strongest risk factor for the development of CAD. Most cases of CAD become clinically apparent in patients aged 40 years

2014 eMedicine.com

79. Gastric Ulcers (Diagnosis)

with uncomplicated PUD, routine laboratory tests usually are not helpful; instead, documentation of PUD depends on radiographic and endoscopic confirmation. Testing for H pylori infection is essential in all patients with peptic ulcers. Rapid urease tests are considered the endoscopic diagnostic test of choice. Of the noninvasive tests, fecal antigen testing is more accurate than antibody testing and is less expensive than urea breath tests but either is reasonable. A fasting serum gastrin level should (...) . For patient education resources, see as well as , , and . Previous References [Guideline] Chey WD, Wong BC. American College of Gastroenterology guideline on the management of Helicobacter pylori infection. Am J Gastroenterol . 2007 Aug. 102(8):1808-25. . Javid G, Zargar SA, U-Saif R, et al. Comparison of p.o. or i.v. proton pump inhibitors on 72-h intragastric pH in bleeding peptic ulcer. J Gastroenterol Hepatol . 2009 Jul. 24(7):1236-43. . Lai KC, Lam SK, Chu KM, et al. Lansoprazole for the prevention

2014 eMedicine.com

80. Bronchiectasis (Diagnosis)

of gastroesophageal reflux is a risk factor for aspiration and that the organism Helicobacter pylori may play a role in the development of bronchiectasis in this group of patients. [ , , ] Cystic fibrosis CF is a multisystem disorder that affects the chloride transport system in exocrine tissues, primarily secondary to a defect in the CF transmembrane regulator (CFTR) protein. CF and its variants are the most common cause of bronchiectasis in the United States and other industrialized nations. CF is an autosomal (...) -expected prevalence, with a 4-fold higher rate of bronchiectasis than the general population. [ ] Overall, identifying the true frequency remains a challenge, given the lack of specific symptoms and lack of readily available noninvasive screening tests for population studies. Race-, sex-, and age-related demographics No racial predilection exists other than those that may be associated with socioeconomic status. Evidence suggests that non–CF-related bronchiectasis is more common and more virulent

2014 eMedicine.com

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