Eficacia de la determinación fecal de Helicobacter pylori mediante la técnica HpSA en enfermos con hemorragia digestiva alta
Efficacy of the fecal determination of helicobacter pylori by the hpsa test in patients with upper gastrointestinal hemorrhage
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Buti, R. Jardí, A. Bosch, F. Rodríguez, G. Sánchez, R. Pinto, X. Costa, J.F. Sánchez-Ávila, M. Cotrina, R. Esteban, J. Guardia" "autores" => array:11 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Buti" ] 1 => array:2 [ "nombre" => "R." "apellidos" => "Jardí" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Bosch" ] 3 => array:2 [ "nombre" => "F." "apellidos" => "Rodríguez" ] 4 => array:2 [ "nombre" => "G." "apellidos" => "Sánchez" ] 5 => array:2 [ "nombre" => "R." "apellidos" => "Pinto" ] 6 => array:2 [ "nombre" => "X." "apellidos" => "Costa" ] 7 => array:2 [ "nombre" => "J.F." "apellidos" => "Sánchez-Ávila" ] 8 => array:2 [ "nombre" => "M." "apellidos" => "Cotrina" ] 9 => array:2 [ "nombre" => "R." "apellidos" => "Esteban" ] 10 => array:2 [ "nombre" => "J." "apellidos" => "Guardia" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210570501701240?idApp=UINPBA00004N" "url" => "/02105705/0000002400000001/v1_201307171022/S0210570501701240/v1_201307171022/es/main.assets" ] "es" => array:13 [ "idiomaDefecto" => true "titulo" => "Eficacia de la determinación fecal de <span class="elsevierStyleItalic">Helicobacter pylori</span> mediante la técnica HpSA en enfermos con hemorragia digestiva alta" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "5" "paginaFinal" => "8" ] ] "autores" => array:2 [ 0 => array:3 [ "autoresLista" => "J. Muñoz Molinero, F. Rodríguez López, F. López Rubio" "autores" => array:3 [ 0 => array:3 [ "nombre" => "J. Muñoz" "apellidos" => "Molinero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "F. Rodríguez" "apellidos" => "López" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "F. López" "apellidos" => "Rubio" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicios de Microbiología Hospital Universitario Reina Sofía. Córdoba" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Anatomía Patológica. Hospital Universitario Reina Sofía. Córdoba" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 1 => array:4 [ "autoresLista" => "D. López Peñas, A. Naranjo Rodríguez, C. Gálvez Calderón, M. Chicano Gallardo, G. Miño Fugarolas" "autores" => array:5 [ 0 => array:3 [ "nombre" => "D. López" "apellidos" => "Peñas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "A. Naranjo" "apellidos" => "Rodríguez" ] 2 => array:2 [ "nombre" => "C. Gálvez" "apellidos" => "Calderón" ] 3 => array:2 [ "nombre" => "M. Chicano" "apellidos" => "Gallardo" ] 4 => array:2 [ "nombre" => "G. Miño" "apellidos" => "Fugarolas" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Unidad Clínica de Aparato Digestivo Hospital Universitario Reina Sofía. Córdoba" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Dr. D. López Peñas. Marcos Redondo, 11, 4.o, 189. 14010 Córdoba." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Efficacy of the fecal determination of <span class="elsevierStyleItalic">helicobacter pylori</span> by the hpsa test in patients with upper gastrointestinal hemorrhage" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2000-03-13" "fechaAceptado" => "2000-06-14" "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Fundamento</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La prueba rápida de ureasa (TRU) es la más difundida en el diagnóstico de infección por <span class="elsevierStyleItalic">Helicobacter pylori</span> en enfermos con hemorragia digestiva alta (HDA), pero algunos estudios sugieren que con frecuencia es negativo falso en presencia de sangre. Recientemente ha surgido una técnica que determina antígenos de <span class="elsevierStyleItalic">Helicobacter pylori</span> en heces mediante enzima de inmunoanálisis (HpSA) eficaz en el diagnóstico de infección (HpSA).</p> <span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudiar la validez de la técnica HpSA en la hemorragia digestiva alta.</p> <span class="elsevierStyleSectionTitle">Pacientes y métodos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se incluyó a 32 pacientes con hemorragia digestiva alta estudiados prospectivamente desde noviembre de 1998 a abril de 1999. En las 72 h siguientes al inicio del sangrado y las 24 h posteriores al ingreso se realizó a todos endoscopia digestiva alta con toma de biopsias para TRU y estudio histológico, se recogieron muestras de sangre para serología y de heces para HpSA y se realizó la prueba del aliento con urea marcada con 13C (TAU). Se definió la existencia de infección por la positividad de al menos dos de cuatro técnicas diagnósticas, exceptuando la técnica HpSA. Se calcularon sensibilidad, especificidad, valor predictivo positivo y valor predictivo negativo.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El 71,8% (23/32) tuvieron infección. Cuatro HpSA (12,5%) resultaron negativos y 28 positivos (87,5%). El HpSA puso de manifiesto alta sensibilidad (95,6%) pero baja especificidad (33,3%). El valor predictivo positivo y el valor predictivo negativo resultaron del 78,5 y el 75%, respectivamente. De los 32 HpSA, 25 (78,1%) se realizaron en heces melénicas: 22 fueron positivos y tres negativos. El 78,5% de HpSA positivos y el 75% de los negativos correspondieron a heces melénicas.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El HpSA es una técnica rápida, no invasiva, que no parece verse influida por la presencia de sangre por lo que es aplicable en hemorragia digestivo alta. El TRU evidenció altas sensibilidad, especificidad y valor predictivo positivo, por lo que debe seguir como método de primera elección en la hemorragia digestiva alta. El HpSA puede introducirse como segunda técnica, y es útil en los casos con TRU negativo y alta sospecha de infección, cuando no se hayan tomado muestras para TRU y cuando no se pueda efectuar la endoscopia. Los resultados obtenidos en este estudio deberán confirmarse en futuros trabajos de mayor tamaño muestral.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The rapid urease test is the most commonly used test in the diagnosis of <span class="elsevierStyleItalic">Helicobacter pylori</span> infection in patients with upper gastrointestinal hemorrhage. However, some studies have suggested that results of this test are frequently false negative when blood is present. An effective new enzyme immunoassay for determining <span class="elsevierStyleItalic">H. pylori</span> antigens in stools has recently begun to be used.</p> <span class="elsevierStyleSectionTitle">Aim</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">To determine the efficacy of the H. pylori stool antigen test (HpSAT) in patients with upper gastrointestinal hemorrhage.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Thirty-two patients with upper gastrointestinal hemorrhage were prospectively studied from November 1998 to April 1999. In all patients the following tests were performed in the first 72 hours after onset of bleeding and 24 hours after hospital admission: upper gastrointestinal endoscopy, biopsy samples for the rapid urease test and histological study, blood samples for serology, stool samples for HpSAT, and the <span class="elsevierStyleSup">13</span>C urea breath test. Criteria for infection was a positive result in at least two of the four diagnostic techniques, except in the case of HpSAT. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Of the 32 patients, 23 (71.8%) were infected. The results of four HpSAT (12.5%) were negative and 28 were positive (87.5%). HpSAT showed high sensitivity (95.6%)but low specificity (33.3%). The PPV and NPV were 78.5% and 75% respectively. Of the 32 HpSAT, 25 (78.1) were performed in melenic stools: 22 were positive and 3 were negative. Seventy-five percent of negative HpSAT and 78.5% of positive HpSAT corresponded to melenic stools.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">HpSAT is a rapid, non-invasive technique that does not appear to be influenced by the presence of blood. Consequently, it can be applied in patients with upper gastrointestinal hemorhage. The rapid urease test showed high sensitivity, specificity and PPV and should remain the first-line test in patients with upper gastrointestinal hemorrhage. HpSAT is appropriate as a second-line technique and is useful when the rapid urease test is negative and infection is strongly suspected, when no samples for the rapid urease test have been taken and when endoscopy cannot be performed. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 12 | 0 | 12 |
| 2024 Octubre | 113 | 12 | 125 |
| 2024 Septiembre | 92 | 29 | 121 |
| 2024 Agosto | 94 | 14 | 108 |
| 2024 Julio | 96 | 11 | 107 |
| 2024 Junio | 87 | 18 | 105 |
| 2024 Mayo | 77 | 4 | 81 |
| 2024 Abril | 64 | 16 | 80 |
| 2024 Marzo | 61 | 34 | 95 |
| 2024 Febrero | 58 | 7 | 65 |
| 2024 Enero | 86 | 9 | 95 |
| 2023 Diciembre | 92 | 23 | 115 |
| 2023 Noviembre | 74 | 25 | 99 |
| 2023 Octubre | 95 | 31 | 126 |
| 2023 Septiembre | 75 | 16 | 91 |
| 2023 Agosto | 80 | 13 | 93 |
| 2023 Julio | 103 | 28 | 131 |
| 2023 Junio | 88 | 19 | 107 |
| 2023 Mayo | 93 | 12 | 105 |
| 2023 Abril | 70 | 6 | 76 |
| 2023 Marzo | 84 | 19 | 103 |
| 2023 Febrero | 49 | 5 | 54 |
| 2023 Enero | 53 | 3 | 56 |
| 2022 Diciembre | 55 | 14 | 69 |
| 2022 Noviembre | 75 | 26 | 101 |
| 2022 Octubre | 50 | 16 | 66 |
| 2022 Septiembre | 46 | 25 | 71 |
| 2022 Agosto | 64 | 17 | 81 |
| 2022 Julio | 58 | 18 | 76 |
| 2022 Junio | 38 | 16 | 54 |
| 2022 Mayo | 47 | 15 | 62 |
| 2022 Abril | 55 | 15 | 70 |
| 2022 Marzo | 41 | 15 | 56 |
| 2022 Febrero | 40 | 10 | 50 |
| 2022 Enero | 46 | 15 | 61 |
| 2021 Diciembre | 58 | 18 | 76 |
| 2021 Noviembre | 52 | 5 | 57 |
| 2021 Octubre | 69 | 17 | 86 |
| 2021 Septiembre | 49 | 10 | 59 |
| 2021 Agosto | 27 | 10 | 37 |
| 2021 Julio | 27 | 7 | 34 |
| 2021 Junio | 37 | 11 | 48 |
| 2021 Mayo | 36 | 8 | 44 |
| 2021 Abril | 70 | 23 | 93 |
| 2021 Marzo | 64 | 15 | 79 |
| 2021 Febrero | 39 | 12 | 51 |
| 2021 Enero | 37 | 8 | 45 |
| 2020 Diciembre | 37 | 12 | 49 |
| 2020 Noviembre | 50 | 11 | 61 |
| 2020 Octubre | 31 | 15 | 46 |
| 2020 Septiembre | 43 | 20 | 63 |
| 2020 Agosto | 25 | 11 | 36 |
| 2020 Julio | 35 | 16 | 51 |
| 2020 Junio | 35 | 5 | 40 |
| 2020 Mayo | 33 | 17 | 50 |
| 2020 Abril | 25 | 12 | 37 |
| 2020 Marzo | 19 | 20 | 39 |
| 2020 Febrero | 31 | 22 | 53 |
| 2020 Enero | 28 | 58 | 86 |
| 2019 Diciembre | 27 | 55 | 82 |
| 2019 Noviembre | 12 | 34 | 46 |
| 2019 Octubre | 22 | 27 | 49 |
| 2019 Septiembre | 33 | 55 | 88 |
| 2019 Agosto | 16 | 23 | 39 |
| 2019 Julio | 33 | 45 | 78 |
| 2019 Junio | 68 | 87 | 155 |
| 2019 Mayo | 163 | 137 | 300 |
| 2019 Abril | 61 | 153 | 214 |
| 2019 Marzo | 18 | 66 | 84 |
| 2019 Febrero | 20 | 94 | 114 |
| 2019 Enero | 12 | 34 | 46 |
| 2018 Diciembre | 12 | 28 | 40 |
| 2018 Noviembre | 24 | 23 | 47 |
| 2018 Octubre | 12 | 14 | 26 |
| 2018 Septiembre | 17 | 30 | 47 |
| 2018 Agosto | 5 | 88 | 93 |
| 2018 Julio | 4 | 91 | 95 |
| 2018 Junio | 3 | 44 | 47 |
| 2018 Mayo | 2 | 31 | 33 |
| 2018 Abril | 4 | 14 | 18 |
| 2018 Marzo | 6 | 18 | 24 |
| 2018 Febrero | 1 | 8 | 9 |
| 2018 Enero | 2 | 7 | 9 |
| 2017 Diciembre | 0 | 5 | 5 |
| 2017 Noviembre | 9 | 8 | 17 |
| 2017 Octubre | 5 | 12 | 17 |
| 2017 Septiembre | 3 | 8 | 11 |
| 2017 Agosto | 3 | 8 | 11 |
| 2017 Julio | 4 | 10 | 14 |
| 2017 Junio | 4 | 7 | 11 |
| 2017 Mayo | 5 | 7 | 12 |
| 2017 Abril | 8 | 2 | 10 |
| 2017 Marzo | 10 | 36 | 46 |
| 2017 Febrero | 11 | 2 | 13 |
| 2017 Enero | 5 | 0 | 5 |
| 2016 Diciembre | 18 | 9 | 27 |
| 2016 Noviembre | 18 | 4 | 22 |
| 2016 Octubre | 24 | 2 | 26 |
| 2016 Septiembre | 13 | 6 | 19 |
| 2016 Agosto | 11 | 1 | 12 |
| 2016 Julio | 10 | 1 | 11 |
| 2016 Junio | 18 | 6 | 24 |
| 2016 Mayo | 16 | 2 | 18 |
| 2016 Abril | 14 | 1 | 15 |
| 2016 Marzo | 18 | 3 | 21 |
| 2016 Febrero | 17 | 0 | 17 |
| 2016 Enero | 6 | 0 | 6 |
| 2015 Diciembre | 10 | 3 | 13 |
| 2015 Noviembre | 25 | 3 | 28 |
| 2015 Octubre | 24 | 2 | 26 |
| 2015 Septiembre | 14 | 1 | 15 |
| 2015 Agosto | 19 | 0 | 19 |
| 2015 Julio | 7 | 2 | 9 |
| 2015 Junio | 6 | 3 | 9 |
| 2015 Mayo | 7 | 1 | 8 |
| 2015 Abril | 15 | 6 | 21 |
| 2015 Marzo | 16 | 7 | 23 |
| 2015 Febrero | 12 | 1 | 13 |
| 2015 Enero | 9 | 1 | 10 |
| 2014 Diciembre | 9 | 0 | 9 |
| 2014 Noviembre | 11 | 1 | 12 |
| 2014 Octubre | 5 | 0 | 5 |
| 2014 Septiembre | 9 | 0 | 9 |
| 2014 Agosto | 3 | 0 | 3 |
| 2014 Julio | 4 | 0 | 4 |
| 2014 Junio | 5 | 0 | 5 |
| 2014 Mayo | 7 | 0 | 7 |
| 2014 Abril | 4 | 1 | 5 |
| 2014 Marzo | 5 | 1 | 6 |
| 2014 Febrero | 1 | 3 | 4 |
| 2014 Enero | 4 | 2 | 6 |
| 2013 Diciembre | 4 | 4 | 8 |
| 2013 Noviembre | 12 | 2 | 14 |
| 2013 Octubre | 5 | 0 | 5 |
| 2013 Septiembre | 7 | 0 | 7 |
| 2013 Agosto | 7 | 1 | 8 |
| 2013 Julio | 1 | 0 | 1 |
| 2001 Enero | 2311 | 0 | 2311 |
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