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Modified Helicobacter test using a new test meal and a 13C-urea breath test in Helicobacter pylori positive and negative dyspepsia patients on proton pump inhibitors

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World Journal of Gastroenterology 2017年第32期23卷 5954-5961页

作者： bojan tepes Peter Malfertheiner Joachim Labenz Sitke Aygen AM DC Rogaska Prvomajska 29 A3250 Rogaska SlatinaSlovenia Universitatsklinikum Magdeburg A.o.R Klinik für Gastroenterologie Hepatologie und Infektiologie39120 MagdeburgGermany Department of Internal Medicine and Gastroenterology Diakonie KlinikumJung-Stilling Hospital Institut für Biomedizinische Analytik und NMR-Imaging GmbH(INFAI)

AIM To determine the sensitivity and specificity of the ^(13)C-urea breath test(UBT) in patients taking proton pump inhibitors(PPIs), using a new test meal Refex. METHODS One hundred and fourteen consecutive patients with dyspepsia, 53 Helicobacter pylori(H. pylori) positive, 49 H. pylori negative, were included in the study. The patients were then given esomeprazole 40 mg for 29 consecutive days, and the ^(13)C-UBT with the new test meal was performed the next morning. RESULTS The sensitivity of the ^(13)C-UBT with a cut off 2.5‰ was92.45%(95%CI: 81.79%-97.91%) by per-protocol(PP) analysis and 78.13 %(95%CI: 66.03%-87.49%) by intention-to-treat(ITT) analysis. The specificity of the ^(13)C-UBT test was 96.00 % in the ITT population(95%CI: 86.29%-99.51%) and 97.96% in the PP population(95%CI: 89.15%-99.95%).CONCLUSION The new test meal based ^(13)C-UBT is highly accurate in patients on PPIs and can be used in those unable to stop their PPI treatment.

关键词： Urea breath test new test meal Proton pump inhibitors Prospective randomized clinical trial Helicobacter pylori

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Impact of a clinical pathway on treatment outcome in patients with acute pancreatitis

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World Journal of Gastroenterology 2015年第30期21卷 9150-9155页

作者： Miroslav Vujasinovic Jana Makuc bojan tepes Apolon Marolt Zdenko Kikec Nace Robac Department of Internal Medicine General Hospital Slovenj Gradec Abakus Medico Diagnostic Centre Rogaska

AIM:To determine the impact of a clinical pathway(CP) on acute pancreatitis(AP) treatment ***:A retrospective analysis of medical records was performed. We compared the results of AP treatment outcome over two time periods in our centre,before(2006-2007) and after(2010-2012) the implementation of a CP. The CP comprised the following indicators of quality:performance of all laboratory tests on admission(including lipids and carbohydrate deficient transferrin),determination of AP aetiology,abdomen ultrasound(US) within the first 24 h after admission,contrast-enhanced computed tomography of the abdomen in all cases of suspected pancreatic necrosis,appropriately selected and sufficiently used antibiotic therapy(if necessary),pain control,adequate hydration,control of haemodynamic parameters and transfer to the Intensive Care Unit(ICU)(if necessary),endoscopic retrograde cholangiopancreatography(ERCP) in biliary AP,surgical treatment(if necessary),and advice on outpatient follow-up after discharge. A comparison of the length of stay with that in other Slovenian hospitals was also ***:There were 139 patients treated in the three-year period after the introduction of a CP,of which 81(58.3%) were male and 58(41.7%) female. The patients' mean age was 59.6 ± 17.3 years. The most common aetiologies were alcoholism and gallstones(38.8% each),followed by unexplained(11.5%),drug-induced,hypertriglyceridemia,post ERCP(2.9% each) and tumours(2.2%). Antibiotic therapy was prescribed in 72(51.8%) patients. Abdominal US was performed in all patients within the first 24 h after admission. Thirty-two(23.0%) patients were treated in the ICU. Four patients died(2.9%). In comparison to 2006-2007,we found an increased number of alcoholic and biliary AP and an associateddecrease in the number of unexplained aetiology cases. The use of antibiotics also significantly decreased after the implementation of a CP(from 70.3% to 51.8%; P = 0.003). There was no statistically

关键词： Acute Pancreatitis Treatment Clinicalpathway Indicator Quality

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Pancreatic exocrine insufficiency, diabetes mellitus and serum nutritional markers after acute pancreatitis

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World Journal of Gastroenterology 2014年第48期20卷 18432-18438页

作者： Miroslav Vujasinovic bojan tepes Jana Makuc Sasa Rudolf Jelka Zaletel Tjasa Vidmar Maja Seruga Bostjan Birsa Miroslav Vujasinovic Jana Makuc Tjasa Vidmar Department of Internal Medicine Slovenj Gradec General Hospital Slovenj Gradec 2380 Slovenia Abakus Medico Diagnostic Centre Rogaska Slatina 3250 Slovenia Department of Radiology University Medical Centre Maribor Maribor 2000 Slovenia Department of Endocrinology Diabetes and Metabolic Diseases University Medical Centre Ljubljana Ljubljana 1000 Slovenia Department of Internal Medicine Murska Sobota General Hospital Murska Sobota 9001 Slovenia Department of Internal Medicine Celje General Hospital Celje 3000 Slovenia

AIM: To investigate impairment and clinical significance of exocrine and endocrine pancreatic function in patients after acute pancreatitis (AP).

关键词： Acute pancreatitis Diabetes mellitus Pancreatic exocrine insufficiency Serum nutritional markers

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