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[15/19] Helicobacter pylori Eradication after the Standard 'Maastricht Triple Therapy': Which are the Predictors of Failure? Background: Short-term triple therapy with PPI, clarithromycin, and amoxycillin has been proposed by the [...]

[15/07] [*] Ranititine Bismuth Citrate (RBC) plus Amoxycillin and Tinidazole: A useful Second-Line Regimen After Failure of the Standard 'Triple Therapy' Background: Triple therapy with PPI, clarythromycin (CLA), and amoxycillin [...]

[10/11] HLA-DQA1 and -DQB1 Genes and Helicobacter pylori infection in Italian Patients with Gastric Adenocarcinoma Background: Both HLA-DQA1 and -DQB1 genes and Helicobacter pylori infection have been linked to gastric [...]

Summary Background: 13 C breath test analysis requires accurate 13 CO2 measurements. Aim: To perform a multicentre study to evaluate the repeatability and reproducibility of breath 13 CO2 analysis. Methods: Two series of 25 paired randomly coded tubes (each consisting of 23 13 CO2 -enriched breath samples and two samples of standard reference pure CO2 with certified δ 13 CPDB ) were sent to participating centres for 13 CO2 measurement. Each series of tubes was analysed 10 days apart. The repeatability and reproducibility of 13 C measurements was assessed by Mandel's k and h statistics. Results: Twenty-two centres participated in the study: 18 showed good inter- and intra-laboratory variability, whilst four showed abnormally high inter- or intra-laboratory variability. Breath test results were also significantly affected by the accuracy of the 13 C analytical procedures. Conclusions: A low accuracy of 13 C measurements may significantly affect the results of breath tests, leading to inappropriate clinical decisions. Standardization of 13 C analysis is required to guarantee optimal 13 C measurements and accurate 13 C breath test results. [ABSTRACT FROM AUTHOR]

Unlabelled: Several gastrointestinal motor abnormalities have been detected in patients with celiac disease, but it is unclear whether they are able to influence the gastric emptying rate. The aim of this work was to evaluate the gastric emptying rate of solids in children with celiac disease before and after a gluten-free diet. Nine children with celiac disease and nine healthy controls (age range 4-16 y) underwent a 13C-octanoic acid breath test to measure gastric emptying. Half emptying time (t1/2) and lag phase (t(lag)) were calculated. After 6 mo of a gluten-free diet, all celiac children underwent a repeat 13C-octanoic acid breath test. The gastric motility parameters, t1/2 and t(lag), were significantly longer in patients than in controls. No significant correlation between abnormal gastric emptying and specific symptom patterns or severity of histological damage was found. On a gluten-free diet, the gastric emptying rate normalized in all celiac patients. This finding supports the hypothesis that gluten-driven mucosal inflammation might determine motor abnormalities by affecting smooth muscle contractility or impairing the release of neurotransmitters. Alternatively, nutrient malabsorption might determine significant changes in intraluminal milieu, which, in turn, may affect intestinal motor functions.Conclusion: patients affected by celiac disease have a markedly delayed gastric emptying of solids, which returns to normal after gluten withdrawal. [ABSTRACT FROM AUTHOR]

Background: The urea breath test (UBT) has been proposed as the most accurate test for diagnosing Helicobacter pylori infection. The aim of this work was to evaluate the accuracy of the UBT and to compare the results with histologic and endoscopic findings in H. pylori infected patients. Methods: One-hundred-and-seventy-two consecutive dyspeptic outpatients were studied by means of endoscopy (with histology and culture), UBT (75 mg [sup 13]C-urea), and serology. Gastritis was classified in accordance with the Sydney criteria. In H. pylori positive patients, the bacterial load was assessed semiquantitatively, the number of bacteria in histologic specimens being counted. UBT results were expressed either as percentage cumulative dose of [sup 13]CO[sub 2] excreted at 1 h (CD60) or delta over baseline at 30′ (DOB30). Results: Of 172 patients, 126 (73%) were H. pylori positive on histology or culture. Using a cut-off value of 3.3 for DOB30, the sensitivity, specificity and accuracy of the UBT were 96%, 93.5%, and 95.3%, respectively. A significant correlation was observed between DOB30 values and intragastric bacterial load (r = 0.32). Moreover, a significant difference in DOB30 values was found between patients sorted by the depth of inflammation (χ[sup 2] = 4.36, p = 0.036). No correlation was observed between DOB30 and endoscopic findings in H. pylori positive subjects. Conclusions: The UBT is an accurate non-invasive diagnostic tool and can be used to predict both the intragastric bacterial load and the severity of related gastritis. [ABSTRACT FROM AUTHOR]