RESUMO
Background: Infection with Helicobacter pylori is frequent in Chile, and a good test for its diagnosis ideally should be non-invasive, fast, easy and inexpensive. Aim: To report the use of an immunoassay test, that detects antigens of Helicobacter pylori in stools. Material and methods: One hundred and four patients that required an upper gastrointestinal endoscopy were studied. Stool samples were analyzed using an enzymatic immunoassay. These results were compared with those obtained with the urease test and microscopic examination of smears taken from biopsies obtained during the diagnostic endoscopy. Results: In 81 of 83 patients considered to have the infection according to the endoscopic tests, the antigen was also present in the stools. The test was negative in 16 of 21 patients considered to be without the infection. The resulting sensitivity and specificity for the immunoassay was thus 97.6 and 76.2 percent respectively, with positive and negative predictive values of 92.4 and 88.9 percent, respectively. Conclusions: These results are in agreement with those reported in the literature. Further studies are needed to define its usefulness in massive screening, follow up after antibiotic treatments or the detection of coccoid forms of Helicobacter pylori
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Helicobacter pylori , Infecções por Helicobacter , Fezes , Ensaio de Imunoadsorção EnzimáticaRESUMO
La Biopsia Hepática (BH) es un procedimiento de alto valor diagnóstico con mínimas complicaciones y escasa mortalidad Método. Revisión retrospectiva de 349 BH realizadas en el Hospital de la Universidad de Chile en un período de cinco años (1990-1994). Resultados. El 55 por ciento de las biopsias se realizó en mujeres y el 45 por ciento en hombres con una edad promedio general de 50 años. Las pruebas de coagulación promedio fueron tiempo de protrombina de 74 por ciento y recuento plaquetario de 190000. Las principales indicaciones fueron por daño hepático crónico de origen necroinflamatorio (alcohólico, viral o autoinmune) en un 47 por ciento y tumor hepático en un 22 por ciento. El 93 por ciento de las muestras se obtuvo por vía percutánea y el resto por vía transyular, laparoscópica o quirúrgica. El diagnóstico histológico se obtuvo en el 97,5 por ciento de los casos siendo los más frecuentes cirrosis y hepatitis crónica (35 por ciento), esteatosis hepática (13 por ciento) y la colestasis crónica (13 por ciento). Las complicaciones observadas fueron tres casos de hemoperitoneo, dos casos de hemo-neumotórax y un caso de biliperitoneo por punción vesicular. No hubo mortalidad en esta serie. Conclusiones: En el presente trabajo se confirma el valor diagnóstico y seguridad de la BH.
Assuntos
Fígado , Biópsia , Técnicas e Procedimentos Diagnósticos/estatística & dados numéricos , Técnicas e Procedimentos Diagnósticos/instrumentaçãoRESUMO
Background: Endoscopic manometry is the gold standard for the diagnosis of sphincter of Oddi dysfunction. Aim: To report the result of the first 30 endoscopic manometries of sphincter of Oddi performed in a Gastroenterology Service. Patients and methods: Thirty manometries were performed in 28 patients aged 30 to 70 years old (14 females). The papilla was cannulated with a perfused catherter, measuring pressure with external transducers. Results: Deep cannulation of the papilla was achieved in 88 por ciento. Procedure-related complications were not observed in these cases. Normal values were registered in 11 cases with a basal sphincter pressure 15.6ñ10.7 mm Hg, contractions with an amplitude of 92.3ñ35.7 mm Hg and 6.0ñ2.4/ min frequency. The clinical suspicion suspicion of hypertonic dyskinesis was confirmed in 5 cases with an elevated basal pressure of 43.69ñ13.3 mm Hg, an increased frequency of contractions ("tachyoddia") in one, and large spastic contractions of high pressure in other case. In 3 of 5 cases with common bile duct stones, a predominance of retrograde propagation of the contractions was observed with normal pressure. Variable manometric results were observed after endoscopic papillotomy observing a scale from the complete absence of motor activity to normal aphincter function. Conclusions: Endoscopic manometry is a reasonably safe method, of great importance in the diagnosis of fuctional disorders of the sphincter of Oddi
