Accuracy of Urea Breath Test Performed Immediately After Emergency Endoscopy in Peptic Ulcer Bleeding

Velayos, Benito; Fernández-Salazar, Luis; Pons-Renedo, Fernando; Muñoz, Mauricio Pastor; Almaraz, Ana; Aller, R.; Ruiz, Lourdes; Olmo, L. del; Gisbert, Javier P.; González-Hernández, José Manuel

doi:10.1007/s10620-012-2096-5

Cited by 12 publications

(7 citation statements)

References 33 publications

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“…The sensitivity and specificity of SAT are decreased in UGIB patients (133)(134)(135) . In contrast, 13C-UBT consistently presents good sensitivity and specificity for HP diagnosis in UGIB patients (136)(137)(138) . A systematic review and a meta-analysis compared invasive and non-invasive tests and concluded that invasive tests (RUT, histology, and culture) had lower sensitivity in patients with UGIB (139) .…”

Section: Level Of Evidence: 4 Grade Of Recommendation: Cmentioning

confidence: 83%

Ivth Brazilian Consensus Conference on Helicobacter Pylori Infection

Coelho

Marinho

Genta

et al. 2018

Arq. Gastroenterol.

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Significant progress has been obtained since the III Brazilian Consensus Conference on H. pylori infection held in 2012, in Bento Gonçalves, Brazil, and justify a fourth meeting to establish updated guidelines on the current management of H. pylori infection. Therefore, the Núcleo Brasileiro para Estudo do Helicobacter pylori e Microbiota (NBEHPM), association linked to Brazilian Federation of Gastroenterology (FBG) held its fourth meeting again in Bento Gonçalves, RS, Brazil, on August 25-27, 2017. Twenty-six delegates, including gastroenterologists, endoscopists, and pathologists from the five regions of Brazil as well as one international guest from the United States, participated in the meeting. The participants were invited based on their knowledge and contribution to the study of H. pylori infection. The meeting sought to review different aspects of treatment for infection; establish a correlation between infection, dyspepsia, intestinal microbiota changes, and other disorders with a special emphasis on gastric cancer; and reassess the epidemiological and diagnostic aspects of H. pylori infection. Participants were allocated into four groups as follows: 1) Epidemiology and Diagnosis, 2) Dyspepsia, intestinal microbiota and other afections, 3) Gastric Cancer, and, 4) Treatment. Before the consensus meeting, participants received a topic to be discussed and prepared a document containing a recent literature review and statements that should be discussed and eventually modified during the face-to-face meeting. All statements were evaluated in two rounds of voting. Initially, each participant discussed the document and statements with his group for possible modifications and voting. Subsequently, during a second voting in a plenary session in the presence of all participants, the statements were voted upon and eventually modified. The participants could vote using five alternatives: 1) strongly agree; 2) partially agree; 3) undecided; 4) disagree; and 5) strongly disagree. The adopted consensus index was that 80% of the participants responded that they strongly or partially agreed with each statement. The recommendations reported are intended to provide the most current and relevant evidences to management of H. pylori infection in adult population in Brazil.

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Section: Level Of Evidence: 4 Grade Of Recommendation: Cmentioning

confidence: 83%

Ivth Brazilian Consensus Conference on Helicobacter Pylori Infection

Coelho

Marinho

Genta

et al. 2018

Arq. Gastroenterol.

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“…Velayos et al. investigated the accuracy of UBT performed immediately after emergency endoscopy in patients with peptic ulcer bleeding (PUB) by comparing the results with those of UBT performed after hospital discharge, considered the gold standard. The sensitivity and specificity of the early UBT were 86 and 66%, respectively, with a negative predictive value of 50%.…”

Section: Diagnosismentioning

confidence: 99%

Diagnosis and Epidemiology of Helicobacter pylori Infection

et al. 2013

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A limited amount of new information was published in the field of diagnosis and epidemiology of Helicobacter pylori this last year. Besides some improvement in current tests, it is interesting to note the attempts to identify severe disease, for example gastric cancer, by breath analysis using nanomaterialbased sensors. In contrast, the predictive value for gastric cancer and atrophy of pepsinogen determinations was found inadequate.Prevalence studies of H. pylori infection have been carried out in adults and children around the world in the general population but also in specific communities. The usual risk factors were found. In addition, a Japanese study highlighted the role of grandmothers in the familial transmission of H. pylori.A study showed that the infection may not always readily establish itself in children, given the number of transient infections observed. It was also noted that after eradication, a first-year relapse is likely to be a recurrence of the previous infection, while later on it is probably a reinfection with a new strain. Diagnosis General Evaluation of Helicobacter pylori Diagnostic TestsTwo studies evaluating different diagnostic methods in specific settings concluded that histology was the most accurate test: Choi et al.[1] evaluated several tests for detecting H. pylori in Korean patients with bleeding (n = 157) and nonbleeding (n = 247) peptic ulcer. In bleeding patients, the sensitivity and specificity were 92.5 and 96% for histology, 40 and 100% for culture, 85 and 92% for rapid urease test (RUT), and 97 and 56% for serology, respectively. The sensitivities of culture and RUT in bleeding patients were significantly lower than in nonbleeding patients. By contrast, histology was reliable regardless of bleeding. Tian et al. [2] reported a meta-analysis evaluating H. pylori diagnostic methods in patients with partial gastrectomy. The pooled sensitivity and specificity were 93 and 85% for histology, 77 and 89% for urea breath test (UBT), and 79 and 94% for RUT, respectively. They concluded that histology was the most reliable test in this setting. Invasive TestsEndoscopy A multicenter Japanese study evaluated the possibility to diagnose H. pylori by conventional endoscopy and chromoendoscopy using indigo carmine in comparison with histology performed according to the Sydney System, on 275 patients [3].Based on a set of indices including diffuse and spotted redness, enlarged and tortuous folds, and swelling, they achieved a sensitivity of 94% in the corpus and 88% in the antrum. However, the specificity was only 62 and 52%, respectively. Rapid urease testMoon et al. [4] studied 240 patients to compare the efficacy of RUT performed on separate gastric antrum and corpus tissue specimens versus on combined specimens, using histology as a gold standard. Combining tissues prior to RUT increased the detection of H. pylori from 137 (64%) in separate specimens to 148 (69.2%)

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“… 8 In addition, for some specific clinic settings, such as peptic ulcer bleeding, or partial gastrectomy patients, UBT showed relatively low sensitivity and specificity. 9 In contrast, the noninvasive method of serology ( i.e. antibody-based test), although highly sensitive and specific, fails to distinguish between past and current H. pylori infection.…”

Section: Introductionmentioning

confidence: 99%