Search

Aim. To establish the contribution of body mass index (BMI), sex, age, ethanol intake, hepatitis B (HBV) and hepatitis C (HCV) virus infection, coffee and drug consumption, and cigarette smoking to account for an elevated alanine transaminase (ALT) level in the general population. Subjects. A total of 6315 adult subjects from the Dionysos study. Methods. Logistic regression was used to quantify the contribution of the variables of interest to elevated ALT, defined as a value of ALT>60 U/l. Areas under ROC curves (AUCs) were calculated to assess accuracy. Results. All the variables considered, with the exception of coffee and drug consumption, were significant predictors of elevated ALT at univariable analyses. When significant predictors were employed in a multivariable model, age and cigarette smoking were no longer significant. The AUC was 0.77 (95% CI=0.74–0.80) for the multivariable model and 0.64 (95% CI=0.60–0.68) for the univariable BMI model (p

Addross for tzonwepodence: Dr. D. Vaira, I CIinica Medica, Universita di Bologna, Policlinico” S. Orsola”. Bologna, Italy. Fax: +39-05 I -398794. E-mail: vairadin@med.unibo. it Helicobacter pylori (H. pylori) is a human pathogen that causes chronic gastritis, has a role in gastric and duodenal ulcer, is involved in gastric carcinogenesis (so that the germ has been classified as a class I definite gastric carcinogen to human) and is regarded as a possible important factor in at least a subset of patients with functional dyspepsia. H. pylori infection can be diagnosed by either invasive, i.e., requiring endoscopy, or non-invasive techniques, i.e., techniques which do not require endoscopy with biopsy sampling. Each of the available diagnostic techniques has advantages as well as disadvantages and it is now clear that the discussion over the different diagnostic methods cannot be oversimplified by reasoning only in terms of “which is the best diagnostic tool?’ The problem should be more specifically addressed by asking “which is the best diagnostic tool in each delinite situation?’ This means that the choice should take into account various factors such as: are we dealing with normal subjects being screened for epidemiological purposes or with patients referred to the gastroenterologist? Has the patient already failed eradication attempt/s and are we looking for susceptibility to antibodies? Are we aiming only at diagnosing the infection in a clinical setting or are we interested in other possibly relevant factors (i.e., putative markers of increased virulence/pathogenicity of the strain as cagA or vacA) in a research setting? Perhaps, we should also ask “what is the cost of the diagnostic technique employed”? Obviously, if all the factors involved are taken into account, such as the need for endoscopy or for a technician/nurse to assist the patient, need of specific laboratory instrumentation/material (i.e., to evaluate the breath sample) or the availability of facilities already in routine use even in small hospitals or in developing countries (as is usually the case with serology). The possibility of testing stool samples in order to non-invasively diagnose H. pylori infection is discussed here bearing in mind these and other similar questions. Over the last few years, the culture of H. pylori has been obtained from stool samples but it has been also shown that viable organisms are present only in a small percentage of cases I. Despite the difficulties encountered in cultures from stool samples, the fact that the organism was present at all raised the possibility of developing a new non-invasive diagnostic test to detect the bacterial antigen in stool. Over the last two years, an enzymatic immunoassay (EIA) which detects the presence of H. pylori antigen in stool specimens has become available (HpSATM-H. pylori Stool Antigen-Meridian Diagnostics Inc., Cincinnati, OH (USA) and has begun to be tested in clinical practice to compare its performance to that of other diagnostic tests already available. The HpSA test has recently received approval from the United States Food and Drugs Administration (FDA) with two indications for use: diagnosis of H. pylori infection in adult symptomatic patients, and 2) monitoring response and post-treatment outcome in adult patients. It is clear that such a test, which detects the bacterial antigen in an ongoing infection, is theoretically useful not only for screening, but also as an early predictor of successful treatment. In this section, we will briefly consider the currently available evidence supporting a possible role for this non-invasive diag

erived from 6 patients were cultured at different effecor to target ratios with HER/2neu positive breast cancer ells (MDA-MB-361) pretreated with Herceptin or control ntibody showing a significant increase 4 weeks after RFA p< 0.05). onclusion. Anti-tumour NK cell function can be enhanced y RFA. This observation may be relevant for the develpment of adiuvant immunotherapeutic strategies exploiting irect and antibody dependent NK cell response against priary and secondary liver tumours.