Two Point Analysis 15-Minute &lt;sup&gt;14&lt;/sup&gt;C-Urea Breath Test for Diagnosing &lt;i&gt;Helicobacter pylor&lt;/i&gt;&lt;i&gt;i&lt;/i&gt; Infection

Novis, Ben; Gabay, Gila; Leichtmann, G; Peri, Marta; Bernheim, J; Pomeranz, I

doi:10.1159/000200735

Cited by 10 publications

(3 citation statements)

References 6 publications

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“…27,30 In our study, fresh milk, which is high in lipids, was used as the test meal, and the results were satisfactory. Whether the test meal could be omitted, as has been done with 14 C-UBT, [31][32][33] has not been extensively tested, although there are suggestions that sensitivity and specificity may not be affected. 27 The necessity for a test meal in the 13 C-UBT protocol needs further evaluation.…”

Section: Discussionmentioning

confidence: 99%

Quantification of Helicobacter pylori infection: Simple and rapid 13 C-urea breath test in Taiwan

Wang¹,

Lee

Ding

et al. 1998

Journal of Gastroenterology

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The 13C-urea breath test (13C-UBT) is a non-invasive method for detecting Helicobacter pylori. This study was performed to determine the cutoff value and evaluate the sensitivity and specificity of 13C-UBT in Taiwan. 13C-Urea (100 mg of 99% 13C-labeled urea) was dissolved in 50 ml sterile water for the test. The test meal for delaying gastric emptying was 100 ml fresh milk. Patients fasted for at least 6h. A baseline breath sample was collected 5 min after they had the test meal. Two other samples were collected at 15 and 30 min after the patients ingested the 13C-urea. The test was evaluated in 352 patients after routine upper gastrointestinal endoscopy, and the urease test, culture, and histopathology were taken as the gold standards for detecting H. pylori. According to the receiver operating characteristic (ROC) curves, we chose values of 2.8 and 4.2 excess delta 13CO2 per mil as the cut-off values for 15 and 30 min, respectively, post 13C-urea. The sensitivity and specificity of 13C-UBT were 99% and 93% at 15 min, and 98% and 93% at 30 min post 13C-urea, respectively. The 13C-UBT breath test is an efficient non-invasive method of high sensitivity and high specificity for detecting H. pylori infection. We suggest that the use of fresh milk as the test meal and the detection of excess delta 13CO2 15 min after the ingestion of 13C-urea are suitable for the clinical use of 13C-UBT. This test is simple and rapid.

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Section: Discussionmentioning

confidence: 99%

Quantification of Helicobacter pylori infection: Simple and rapid 13 C-urea breath test in Taiwan

Wang¹,

Lee

Ding

et al. 1998

Journal of Gastroenterology

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“…As regards the time for measurement after ingestion of the urea meal, conducting tests 15 min post urea intake constantly showed the highest sensitivity and specificity (98.39% & 98.71%) respectively. This shows that the 15-min time point is optimal for augmenting the test precision[ 30 ]. In terms of assessment techniques, the meta-analysis revealed differences in sensitivity and specificity.…”

Section: C-ubt Performance: Urea Dose Timing Of Assessment and Choice...mentioning

confidence: 99%

Evaluation of urea breath test as a diagnostic tool for Helicobacter pylori infection in adult dyspeptic patients

Said,

El-Nasser

2024

World J Gastroenterol

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In this editorial, we discuss the article in the World Journal of Gastroenterology . The article conducts a meta-analysis of the diagnostic accuracy of the urea breath test (UBT), a non-invasive method for detecting Helicobacter pylori (H. pylori) infection in humans. It is based on radionuclide-labeled urea. Various methods, both invasive and non-invasive, are available for diagnosing H. pylori infection, including endoscopy with biopsy, serology for immunoglobulin titers, stool antigen analysis, and UBT. Several guidelines recommend UBTs as the primary choice for diagnosing H. pylori infection and for reexamining after eradication therapy. It is used to be the first choice non-invasive test due to their high accuracy, specificity, rapid results, and simplicity. Moreover, its performance remains unaffected by the distribution of H. pylori in the stomach, allowing a high flow of patients to be tested. Despite its widespread use, the performance characteristics of UBT have been inconsistently described and remain incompletely defined. There are two UBTs available with Food and Drug Administration approval: The 13C and 14C tests. Both tests are affordable and can provide real-time results. Physicians may prefer the 13C test because it is non-radioactive, compared to 14C which uses a radioactive isotope, especially in young children and pregnant women. Although there was heterogeneity among the studies regarding the diagnostic accuracy of both UBTs, 13C-UBT consistently outperforms the 14C-UBT. This makes the 13C-UBT the preferred diagnostic approach. Furthermore, the provided findings of the meta-analysis emphasize the significance of precise considerations when choosing urea dosage, assessment timing, and measurement techniques for both the 13C-UBT and 14C-UBT, to enhance diagnostic precision.

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“…The stable isotope 13 C has been used as a tracer to determine substrate oxidation rates and to develop clinical tests for rapid discrimination of digestive and metabolic disorders in glycolytic and gluconeogenic pathways. Breath tests in which samples of exhaled air are collected and analyzed following oral and parenteral administration of 13 C or 14 C labeled substrate have proven effective for measuring glucose utilization (Lacroix et al, 1973), fat absorption (Hofmann and Lauterburg, 1977;Watkins et al, 1982;Turner et al, 1987), for assessing liver (Schneider et al, 1978;Kurumaya et al, 1988) and pancreatic function (Solomons et al, 1977;Watkins et al, 1977), and for diagnosing Helicobacter pyrori infection (Marshall and Surveyor, 1988;Graham et al, 1988;Ormand et al, 1990;Novis et al, 1991) which is associated with gastric and peptic ulcer disease. Kassel et al (1989) proposed the measurement of [U- 13 C]glucose conversion into other metabolites as a diagnostic tool of differentiating enzyme defects associated with congenital lactic acidosis.…”

Section: Introductionmentioning

confidence: 99%

Metabolite and isotopomer balancing in the analysis of metabolic cycles: I. Theory

Klapa

Park

Sinskey

et al. 1999

Biotechnol. Bioeng.

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Proper analysis of label distribution in metabolic pathway intermediates is critical for correct interpretation of experimental data and strategic experimental design. While, for example, 13 C nuclear magnetic resonance (NMR) spectroscopy is usually limited to the measurement of degrees of 13 C enrichment, more information about metabolic fluxes can be extracted from the fine structure of NMR spectra, or molecular weight distributions of isotopomers of metabolic intermediates (measured by gas chromatography-mass spectrometry). For this purpose, rigorous accounting for the contribution of all pathways to label distribution is required, especially contributions resulting from multiple turns of metabolic cycles. In this paper we present a mathematical model developed to analyze isotopomer distributions of tricarboxylic acid cycle (TCA) intermediates following the administration of 13 C (or 14 C) labeled substrates. The theory presented provides the basis to analyze 13 C NMR spectra and molecular weight distributions of metabolites. In a companion paper (Park et al., 1999), the theory is applied to the analysis of several cases of biological significance.

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Two Point Analysis 15-Minute <sup>14</sup>C-Urea Breath Test for Diagnosing <i>Helicobacter pylor</i><i>i</i> Infection

Cited by 10 publications

References 6 publications

Quantification of Helicobacter pylori infection: Simple and rapid 13 C-urea breath test in Taiwan

Quantification of Helicobacter pylori infection: Simple and rapid 13 C-urea breath test in Taiwan

Evaluation of urea breath test as a diagnostic tool for Helicobacter pylori infection in adult dyspeptic patients

Metabolite and isotopomer balancing in the analysis of metabolic cycles: I. Theory

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