Eficacia de cuatro técnicas de amplio uso para el diagnóstico de la infección por Helicobacter pylori en la enfermedad ulcerosa gástrica

José, Fernando Bermejo San; Miguel, Daniel Boixeda de; Prados, Carlos de Argila de Martín; Sacristán, Javier Manzanares; Pons, Víctor Defarges; Almazán, Luis Moreno; Plaza, A García; Gisbert, Javier P.

doi:10.1016/s0014-2565(00)70699-0

Cited by 5 publications

(2 citation statements)

References 24 publications

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“…On the other hand, because there was not a second determination in patients having negative serology without confirmation by other methods, we cannot exclude that some of them were a false negative in patients studied during seroconversion phase. However, there are studies supporting the use of serology, showing a sensitivity ranging between 90% and 95% and specificity between 80% and 90% [21], and also studies from our own country [22]. Second, although eradication was only proven in 63.2% of Hp‐infected patients, there was no clinical relapse in Hp‐infected patients without eradication assessed, so there was no bias.…”

Section: Discussionmentioning

confidence: 92%

Perforated Peptic Ulcer Treated by Simple Closure and Helicobacter Pylori Eradication

et al. 2005

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Simple closure followed by Helicobacter pylori (Hp) eradication has become the most used procedure in perforated ulcer treatment. However, its efficacy and safety are still to be determined. To assess recurrence and re-perforation rates, and as a secondary objective, to analyze Hp infection rates in perforated ulcer patients and controls, we conducted a prospective study. Ninety-two consecutive patients (ages: 19-96 years) were operated on between 1996 and 2002, and treated by simple closure followed by Hp eradication and NSAID avoidance. The data were prospectively collected in a database. Hp infection was diagnosed in 68 patients (73.9%). Thirty-four patients (37%) consumed nonsteroidal anti-inflammatory drugs (NSAIDs), and 23 (25%) had both Hp infection and NSAID antecedents. The perforation was gastric in 4 cases and pre-pyloric, pyloric or duodenal in 88. There were postoperative complications in 24 patients (26%) and 4 patients died (4.3%). Hp eradication was shown in 46 patients. There was clinical ulcer recurrence in 4 (4.3%); in 3 of them recurrence manifested as re-perforation, all in gastric locations. Overall relapse and re-perforation 1-year crude rates were 6.1% and 4.1%, respectively. Crude rates for non-gastric ulcer recurrence were 0 at 1 year and 2.6% at 2 years and for non-gastric ulcer re-perforation rates were 0 at 1 and 2 years. This therapeutic strategy is associated with a low rate of recurrence and no re-perforations in case of duodenal, pyloric, or pre-pyloric perforated ulcers, but it is not acceptable for perforated gastric ulcers.

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Section: Discussionmentioning

confidence: 92%

Perforated Peptic Ulcer Treated by Simple Closure and Helicobacter Pylori Eradication

et al. 2005

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“…La exactitud diagnóstica global del test rápido de la ureasa es ligeramente inferior a la de la histología. Algunos estudios sugieren que la combinación de muestras de antro y cuerpo en el mismo test puede aumentar su fiabilidad146 . 5.2.2.3.…”

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Guía de práctica clínica sobre el manejo del paciente con dispepsia. Actualización 2012

et al. 2012

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The aim of the Clinical Practice Guideline (CPG) on the Management of Patients with Dyspepsia is to generate recommendations on the optimal approach to dyspepsia in the primary care and specialized outpatient setting. The main objective of this CPG is to help to optimize the diagnostic process, identifying patients with a low risk of a serious organic disease (mainly tumoral), who could be safely managed without the need for invasive diagnostic tests and/or referral to a specialist. The importance of this aim lies in the need to accurately diagnose patients with esophagogastric cancer and correctly treat peptic ulcer while, at the same time, reduce negative endoscopies in order to appropriately use the available healthcare resources. This CPG reviews the initial strategies that can be used in patients with uninvestigated dyspepsia and evaluates the possible decision to begin empirical therapy or to investigate the existence of a lesion that could explain the symptoms. This CPG also discusses functional dyspepsia, which encompasses all patients with dyspepsia with no demonstrable cause on endoscopy. Recommendations for the diagnosis and treatment of peptic ulcer and Helicobacter pylori infection are also made. To classify the scientific evidence and strengthen the recommendations, the GRADE (Grading of Recommendations Assessment, Development and Evaluation Working Group) system has been used (http://www.gradeworkinggroup.org/).

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Non-invasive diagnostic tests forHelicobacter pyloriinfection

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Takwoingi

Siddique

et al. 2018

Cochrane Database of Systematic Reviews

153

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In people without a history of gastrectomy and those who have not recently had antibiotics or proton ,pump inhibitors, urea breath tests had high diagnostic accuracy while serology and stool antigen tests were less accurate for diagnosis of Helicobacter pylori infection.This is based on an indirect test comparison (with potential for bias due to confounding), as evidence from direct comparisons was limited or unavailable. The thresholds used for these tests were highly variable and we were unable to identify specific thresholds that might be useful in clinical practice.We need further comparative studies of high methodological quality to obtain more reliable evidence of relative accuracy between the tests. Such studies should be conducted prospectively in a representative spectrum of participants and clearly reported to ensure low risk of bias. Most importantly, studies should prespecify and clearly report thresholds used, and should avoid inappropriate exclusions.

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Eficacia de cuatro técnicas de amplio uso para el diagnóstico de la infección por Helicobacter pylori en la enfermedad ulcerosa gástrica

Cited by 5 publications

References 24 publications

Perforated Peptic Ulcer Treated by Simple Closure and Helicobacter Pylori Eradication

Perforated Peptic Ulcer Treated by Simple Closure and Helicobacter Pylori Eradication

Guía de práctica clínica sobre el manejo del paciente con dispepsia. Actualización 2012

Non-invasive diagnostic tests forHelicobacter pyloriinfection

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