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Helicobacter pylori Noninvasive Testing

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121. Peptic Ulcer: Surgical Perspective (Diagnosis)

.) In most 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 (...) 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 Pediatrics

122. Peptic Ulcer Disease (Diagnosis)

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 Pediatrics

123. Peptic Ulcer Disease (Follow-up)

testing for active H pylori infection may be used. Endoscopy is required to document healing of gastric ulcers and to rule out gastric cancer. This usually is performed 6-8 weeks after the initial diagnosis of peptic ulcer disease (PUD). Documentation of H pylori cure with a noninvasive test, such as the urea breath test or fecal antigen test, is appropriate in patients with complicated ulcers. Given the current understanding of the pathogenesis of PUD, most patients with PUD are treated successfully (...) % of cases. [ ] Ulcers can recur in the absence of successful H pylori eradication. Dual therapies, which are alternative regimens for treating H pylori infection, are usually not recommended as first-line therapy, because of a variable cure rate that is significantly less than the cure rate achieved with triple therapy. Spouses and H pylori –positive family members of H pylori –positive persons should be considered for testing and treatment of H pylori infection, [ ] since mother-to-child transmission

2014 eMedicine Pediatrics

124. Peptic Ulcer: Surgical Perspective (Follow-up)

testing for active H pylori infection may be used. Endoscopy is required to document healing of gastric ulcers and to rule out gastric cancer. This usually is performed 6-8 weeks after the initial diagnosis of peptic ulcer disease (PUD). Documentation of H pylori cure with a noninvasive test, such as the urea breath test or fecal antigen test, is appropriate in patients with complicated ulcers. Given the current understanding of the pathogenesis of PUD, most patients with PUD are treated successfully (...) % of cases. [ ] Ulcers can recur in the absence of successful H pylori eradication. Dual therapies, which are alternative regimens for treating H pylori infection, are usually not recommended as first-line therapy, because of a variable cure rate that is significantly less than the cure rate achieved with triple therapy. Spouses and H pylori –positive family members of H pylori –positive persons should be considered for testing and treatment of H pylori infection, [ ] since mother-to-child transmission

2014 eMedicine Pediatrics

125. Gastritis and Peptic Ulcer Disease (Overview)

.) In most 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 (...) 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 Emergency Medicine

126. Cellulitis (Overview)

factors for serious illness (eg, extremes of age, general debility, immunocompromise) The Infectious Disease Society of America (IDSA) recommends the following blood tests for patients with soft-tissue infection who have signs and symptoms of systemic toxicity [ ] : Blood cultures CBC with differential levels of creatinine, bicarbonate, creatine phosphokinase, and C-reactive protein (CRP) Blood cultures should also be done in the following circumstances [ ] : Moderate to severe disease [ ] (eg (...) , cellulitis complicating lymphedema [ ] ) Cellulitis of specific anatomic sites (eg, facial and especially ocular areas) Patients with a history of contact with potentially contaminated water [ ] Patients with malignancy who are receiving chemotherapy Neutropenia or severe cell-mediated immunodeficiency Animal bites Other tests to consider are as follows: Mycologic investigations are advisable if recurrent episodes of cellulitis are suspected to be secondary to tinea pedis or onychomycosis Creatinine

2014 eMedicine Emergency Medicine

127. Gastritis and Peptic Ulcer Disease (Follow-up)

testing for active H pylori infection may be used. Endoscopy is required to document healing of gastric ulcers and to rule out gastric cancer. This usually is performed 6-8 weeks after the initial diagnosis of peptic ulcer disease (PUD). Documentation of H pylori cure with a noninvasive test, such as the urea breath test or fecal antigen test, is appropriate in patients with complicated ulcers. Given the current understanding of the pathogenesis of PUD, most patients with PUD are treated successfully (...) % of cases. [ ] Ulcers can recur in the absence of successful H pylori eradication. Dual therapies, which are alternative regimens for treating H pylori infection, are usually not recommended as first-line therapy, because of a variable cure rate that is significantly less than the cure rate achieved with triple therapy. Spouses and H pylori –positive family members of H pylori –positive persons should be considered for testing and treatment of H pylori infection, [ ] since mother-to-child transmission

2014 eMedicine Emergency Medicine

128. Expression of AID, P53, and Mlh1 proteins in endoscopically resected differentiated-type early gastric cancer Full Text available with Trip Pro

to the Vienna classification system, and 11 samples were submucosal invasive carcinomas. All of the EGCs were histologically differentiated carcinomas. All patients were classified as having Helicobacter pylori (H. pylori) infections by endoscopic atrophic changes or by testing seropositive for H. pylori IgG. All of the samples were histopathologically classified as either tubular or papillary adenocarcinoma according to their structure. The immunohistochemical staining was performed in a blinded manner (...) Expression of AID, P53, and Mlh1 proteins in endoscopically resected differentiated-type early gastric cancer To analyze the expression of the tumor-related proteins in differentiated-type early gastric carcinoma (DEGC) samples.Tumor specimens were obtained from 102 patients (75 males and 27 females) who had received an endoscopic tumor resection at Tottori University Hospital between 2007 and 2009. Ninety-one cancer samples corresponded to noninvasive or intramucosal carcinoma according

2012 World journal of gastrointestinal oncology

129. Bacterial Overgrowth Syndrome

knowledge Helicobacter pylori Infection People with Helicobacter pylori infection are 3 to 6 times more likely to develop stomach cancer. Which of the following cancers is NOT associated with H. pylori infection? Adenocarcinoma of the antrum Adenocarcinoma of the gastric body Cancer of the gastric cardia Gastric lymphoma NEWS & VIDEOS Stereotactic Body RT Promising for Low-, Intermediate-Risk PCa TUESDAY, March 5, 2019 (HealthDay News) -- In men with low-risk and intermediate-risk prostate cancer (...) of the antibiotics can worsen symptoms of diarrhea, establishing a definitive etiology is preferred. The standard for diagnosis of bacterial overgrowth syndrome is quantitative culture of intestinal fluid aspirate showing a bacterial count > 10 5 /mL. This method, however, requires endoscopy. Breath tests, using substrates like glucose, lactulose , and xylose, are noninvasive and easy to do. The 14 C-xylose breath test (see ) seems to perform better than the other breath tests. If the anatomic alterations

2013 Merck Manual (19th Edition)

130. Acute Pancreatitis

Acute Pancreatitis Acute Pancreatitis - Gastrointestinal Disorders - MSD Manual Professional Edition Brought to you by The trusted provider of medical information since 1899 SEARCH SEARCH MEDICAL TOPICS Common Health Topics Resources QUIZZES & CASES Quizzes Cases The trusted provider of medical information since 1899 SEARCH SEARCH MEDICAL TOPICS Common Health Topics Resources QUIZZES & CASES Quizzes Cases / / / / IN THIS TOPIC OTHER TOPICS IN THIS CHAPTER Test your knowledge Helicobacter pylori (...) Infection People with Helicobacter pylori infection are 3 to 6 times more likely to develop stomach cancer. Which of the following cancers is NOT associated with H. pylori infection? Adenocarcinoma of the antrum Adenocarcinoma of the gastric body Cancer of the gastric cardia Gastric lymphoma NEWS & VIDEOS Low-Dose Aspirin Does Not Cut Death From Prostate Cancer MONDAY, March 4, 2019 (HealthDay News) -- Low-dose aspirin use does not appear to reduce the overall risk for prostate cancer death, according

2013 Merck Manual (19th Edition)

131. Overview of Malabsorption

Helicobacter pylori Infection People with Helicobacter pylori infection are 3 to 6 times more likely to develop stomach cancer. Which of the following cancers is NOT associated with H. pylori infection? Adenocarcinoma of the antrum Adenocarcinoma of the gastric body Cancer of the gastric cardia Gastric lymphoma NEWS & VIDEOS Stereotactic Body RT Promising for Low-, Intermediate-Risk PCa TUESDAY, March 5, 2019 (HealthDay News) -- In men with low-risk and intermediate-risk prostate cancer, stereotactic body (...) for malabsorption assess fat malabsorption because it is relatively easy to measure. Confirmation of carbohydrate malabsorption is not helpful once steatorrhea is documented. Tests for protein malabsorption are rarely used because fecal nitrogen is difficult to measure. Direct measurement of fecal fat from a 72-h stool collection is the gold standard test for establishing steatorrhea but unnecessary with gross steatorrhea of obvious cause. However, this test is available routinely in only a few centers. Stool

2013 Merck Manual (19th Edition)

132. Diagnostic and Therapeutic GI Procedures - Endoscopy

knowledge Helicobacter pylori Infection People with Helicobacter pylori infection are 3 to 6 times more likely to develop stomach cancer. Which of the following cancers is NOT associated with H. pylori infection? Adenocarcinoma of the antrum Adenocarcinoma of the gastric body Cancer of the gastric cardia Gastric lymphoma NEWS & VIDEOS February 2019 Briefing - Gastroenterology Here are what the editors at HealthDay consider to be the most important developments in Gastroenterology for February 2019 (...) Diagnostic and Therapeutic GI Procedures - Endoscopy Endoscopy - Gastrointestinal Disorders - MSD Manual Professional Edition Brought to you by The trusted provider of medical information since 1899 SEARCH SEARCH MEDICAL TOPICS Common Health Topics Resources QUIZZES & CASES Quizzes Cases The trusted provider of medical information since 1899 SEARCH SEARCH MEDICAL TOPICS Common Health Topics Resources QUIZZES & CASES Quizzes Cases / / / / IN THIS TOPIC OTHER TOPICS IN THIS CHAPTER Test your

2013 Merck Manual (19th Edition)

133. Atherosclerosis

in atherogenesis. C. pneumoniae infection or other infections (eg, viral, Helicobacter pylori ) may cause endothelial dysfunction through direct infection, exposure to endotoxin, or stimulation of systemic or subendothelial inflammation. promotes development of atherosclerosis via several pathways, including worsening hypertension and insulin resistance; decreased apolipoprotein A-I levels; and increased lipoprotein(a), homocysteine, fibrinogen, and C-reactive protein levels. is often followed by accelerated (...) manifest as pain, a pulsatile mass, absent pulses, or sudden death. Diagnosis Approach depends on the presence or absence of symptoms. Symptomatic patients Patients with symptoms and signs of ischemia are evaluated for the amount and location of vascular occlusion by various invasive and noninvasive tests, depending on the organ involved (see elsewhere in T he M anual ). Such patients also should be evaluated for atherosclerosis risk factors by using History and physical examination Fasting lipid

2013 Merck Manual (19th Edition)

134. Esophageal Cancer

Esophageal Cancer Esophageal Cancer - Gastrointestinal Disorders - MSD Manual Professional Edition Brought to you by The trusted provider of medical information since 1899 SEARCH SEARCH MEDICAL TOPICS Common Health Topics Resources QUIZZES & CASES Quizzes Cases The trusted provider of medical information since 1899 SEARCH SEARCH MEDICAL TOPICS Common Health Topics Resources QUIZZES & CASES Quizzes Cases / / / / IN THIS TOPIC OTHER TOPICS IN THIS CHAPTER Test your knowledge Helicobacter pylori (...) Infection People with Helicobacter pylori infection are 3 to 6 times more likely to develop stomach cancer. Which of the following cancers is NOT associated with H. pylori infection? Adenocarcinoma of the antrum Adenocarcinoma of the gastric body Cancer of the gastric cardia Gastric lymphoma NEWS & VIDEOS Stereotactic Body RT Promising for Low-, Intermediate-Risk PCa TUESDAY, March 5, 2019 (HealthDay News) -- In men with low-risk and intermediate-risk prostate cancer, stereotactic body radiotherapy

2013 Merck Manual (19th Edition)

135. Peptic ulcer

taking certain drugs, such as or . The diagnosis of can be made by: (noninvasive and does not require EGD); Direct culture from an EGD biopsy specimen; this is difficult to do, and can be expensive. Most labs are not set up to perform H. pylori cultures; Direct detection of activity in a biopsy specimen by ; Measurement of levels in the blood (does not require EGD). It is still somewhat controversial whether a positive antibody without EGD is enough to warrant eradication therapy; Stool test (...) , weight loss, or . About a third of older people have no symptoms. Complications may include , and . Bleeding occurs in as many as 15% of people. Common causes include the and (NSAIDs). Other less common causes include , stress due to serious illness, , , and , among others. Older people are more sensitive to the ulcer-causing effects of NSAIDs. The diagnosis is typically suspected due to the presenting symptoms with confirmation by either or . H. pylori can be diagnosed by testing the blood

2012 Wikipedia

136. Accuracy of Diagnostic Tests for Helicobacter pylori: A Reappraisal. Full Text available with Trip Pro

Accuracy of Diagnostic Tests for Helicobacter pylori: A Reappraisal. Despite many changes, no large studies comparing the different diagnostic tests for Helicobacter pylori have been performed in the past 10 years. In this time, monoclonal stool antigen immunoassays and in-office 13C-urea breath tests (UBTs) have appeared. The aim of this study was to evaluate the accuracy of invasive and noninvasive tests in a large series of dyspeptic patients.A total of 199 dyspeptic patients who had (...) not previously been treated for H. pylori infection were prospectively enrolled. Noninvasive analyses included a commercial infrared-based UBT and a commercially available stool test. Biopsy-based tests included histological examination and a rapid urease test. A patient was considered to be infected when at least 2 test results were positive. Sensitivity, specificity, positive and negative predictive values, and 95% confidence intervals were calculated. The test results were compared using the McNemar

2009 Clinical Infectious Diseases

137. Lack of Diagnostic Accuracy of the Monoclonal Stool Antigen Test for Detection of Helicobacter pylori Infection in Young Australian Aboriginal Children. (Abstract)

Lack of Diagnostic Accuracy of the Monoclonal Stool Antigen Test for Detection of Helicobacter pylori Infection in Young Australian Aboriginal Children. : The prevalence of Helicobacter pylori infection among Aboriginal Australians children is unclear. The aims of the present study are to determine the prevalence of H. pylori infection among young Aboriginal children recovering from acute diarrheal disease in hospital and to evaluate the H. pylori stool antigen test as a noninvasive diagnostic (...) test in this setting.: This was a prospective comparative study using the C-Urea Breath Test as reference standard. Fifty-two children between 4 months and 2 years of age were consecutively enrolled. These children comprised a representative sample of Australian Aboriginal children admitted to hospital with acute diarrheal disease from remote and rural communities across Northern Territory of Australia.: The overall prevalence of H. pylori was 44.2%. The stool antigen test had a sensitivity of 0.55

2009 Pediatric Infectious Dsease Journal

138. Cost-effectiveness of a 'score and scope' strategy for the management of dyspepsia

and scope strategy, a locally validated scoring system was used. If the score was 7 or greater, the patient was at high risk of organic disease and an endoscopy was performed (as described above). In the absence of alarm symptoms or if the score was lower than 7, an antisecretory treatment was given (omeprazole for 2 months). With the test and scope strategy, a urea breath test (UBT) was performed. If the results were positive for Helicobacter pylori (H. pylori) infection, the patient was referred (...) for endoscopy. If the results were negative, the patient was prescribed an antisecretory treatment (omeprazole for 2 months). With the test and treat strategy, a UBT was performed. If the results were positive for H. pylori infection, the patient received an eradication treatment. If the results were negative, the patient was prescribed an antisecretory treatment (omeprazole for 2 months). With the empirical antisecretory treatment strategy, the patients received an antisecretory treatment (omeprazole for 2

2005 NHS Economic Evaluation Database.

139. Alternative management strategies for patients with suspected peptic ulcer disease

followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology The diagnosis and treatment of suspected peptic ulcer using alternative invasive and noninvasive strategies. In particular 1) immediate endoscopy for diagnosing peptic ulcer and biopsy for diagnosing Helicobacter pylori, followed by antisecretory therapy for ulcer treatment and antibiotic therapy for H.pylori treatment; 2) immediate endoscopy without biopsy, followed by antisecretory (...) Paper URL Other publications of related interest Comment in: ACP Journal Club 1996;124(1):24 Indexing Status Subject indexing assigned by NLM MeSH Anti-Bacterial Agents /therapeutic use; Anti-Ulcer Agents /therapeutic use; Biopsy /economics; Cost-Benefit Analysis; Decision Support Techniques; Drug Therapy, Combination; Endoscopy, Gastrointestinal /economics; Helicobacter Infections /drug therapy; Helicobacter pylori; Humans; Peptic Ulcer /drug therapy /microbiology; Recurrence AccessionNumber

1995 NHS Economic Evaluation Database.

140. The effectiveness of endoscopy in the management of dyspepsia: a qualitative systematic review

test was compared The review did not include any diagnostic accuracy studies that compared the performance of the index test with a reference standard of diagnosis. Participants included in the review Clinical studies of patients with dyspepsia (all definitions, including reflux-like dyspepsia) were eligible for inclusion. Patients with variably defined dyspepsia (including reflux-like dyspepsia) were studied. The participants included those who were Helicobacter pylori (H. pylori)-positive (...) resource utilisation in H. pylori-positive dyspepsia: 5 studies screened patients for H. pylori status, which was followed by endoscopy for those older than 45 years of age who tested H. pylori-positive or had recently used non-steroidal anti-inflammatory drugs. Eleven studies assessed the impact of endoscopy on resource use and reported that empiric therapy reduced the use of endoscopy. Only four of these studies defined dyspepsia. The results as to whether the reduction in endoscopy was offset

1999 DARE.

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