Search PubMedSearch

Biomedical subjects

E Ragnhildstveit

Publications and source records attributed to E Ragnhildstveit.

16 recordsLinked to original sources

Accuracy of seven different tests for the diagnosis of Helicobacter pylori infection and the impact of H2-receptor antagonists on test results.

BACKGROUND: In this study we compared the accuracy of seven diagnostic tests in diagnosing Helicobacter pylori infection. METHODS: Over 1 year 351 consecutive dyspeptic patients were tested for H. pylori infection by means of antral biopsy specimens for the rapid urease test (RUT), culture, microscopy (acridine stain), and the laboratory urease test (LUT) and, in addition, with 14C urea breath test (UBT), IgG serology, and IgA serology (Orion Diagnostica Pyloriset New EIA-G and New EIA-A). The criterion for H. pylori infection was a minimum of three positive tests. Before being tested, 38% of the patients had used an H2-receptor antagonist (H2RA). RESULTS: Two-hundred and twenty-four patients (64%) were H. pylori-positive. The sensitivity and specificity of the tests were as follows (percentages): RUT, 85, 99; culture, 93, 100; microscopy, 81, 98; LUT, 80, 100; UBT, 95, 95; IgG serology, 99, 91; and IgA serology, 88, 91. The accuracy of the RUT and LUT was reduced in patients receiving H2RA therapy (P=0.04 and 0.01, respectively). CONCLUSIONS: Culture, UBT, and IgG serology were all superior to the other four tests in diagnosing H. pylori infection. Invasive urease-based tests were less accurate in patients receiving H2RAs.

Biopsy

Accuracy of IgG serology and other tests in confirming Helicobacter pylori eradication.

BACKGROUND: In this study we assessed the accuracy of IgG serology and other tests in confirming Helicobacter pylori eradication. METHODS: The outcome of anti-H. pylori therapy was established by at least two of the following tests: rapid urease test (RUT), culture, 14C urea breath test (non-capsule or capsule UBT), and IgG serology (Orion Diagnostica Pyloriset New EIA-G). RESULTS: Successful H. pylori eradication was confirmed in 698 of 794 patients (88%). The percentage decrease in IgG antibody titre was related to the patients' pre-treatment IgG titre and time interval after treatment. A decrease in IgG titres of 40% or more confirmed H. pylori eradication with 100% specificity, whereas the sensitivity was 82%, 90%, 98%, and 98% 3, 4, 5, and 6 months after therapy, respectively. The 40% cut-off confirmed eradication 3 to 6 months after therapy in 328 of 339 patients (97%) with pre-treatment IgG titres of >700, in 36 of 45 patients (80%) with pre-treatment titres of 300-700, and in 5 of 12 patients (42%) with pretreatment titres of <300. The sensitivity and specificity of the other tests 2 months after treatment were as follows: RUT, 84% and 100%; culture, 88% and 100%; non-capsule UBT, 100% and 89%; and capsule UBT, 100% and 97%. CONCLUSION: A decrease in IgG antibody titre of 40% or more 3 to 6 months after therapy and the capsule 14C UBT at the 2-month follow-up were both highly accurate in confirming H. pylori eradication.

Adult

Simplified 10-day bismuth triple therapy for cure of Helicobacter pylori infection: experience from clinical practice in a population with a high frequency of metronidazole resistance.

OBJECTIVE: To evaluate the cure rate of Helicobacter pylori infection, including the impact of in vitro metronidazole resistance (M-R), and the side effects of a simplified 10-day bismuth triple therapy in routine clinical practice. METHODS: From September 1995 to March 1996, 248 consecutive H. pylori-positive patients received 10 days of bismuth subnitrate 150 mg, oxytetracycline 500 mg, and metronidazole 400 mg, all t.id. Before treatment, upper endoscopy, including biopsy specimens for microbiological analysis and IgG serology were performed. M-R was found in 45% of females and 36% of males. At least 2 months after treatment, H. pylori status was assessed by the 14C urea breath test (n = 131), endoscopy (n = 37), urea breath test and endoscopy (n = 63), or solely by IgG serology (n = 7). Ten patients withdrew. IgG serology was performed again after 1 yr. RESULTS: H. pylori infection was cured in 205 patients: 86% by all-patients-treated analysis and 83% by intention-to-treat analysis. When patients were classified according to pretreatment metronidazole susceptibility, cure of infection was achieved in 76% of females harboring M-R strains versus 96% of those with sensitive strains (p = 0.002) and in 81% versus 88% (p = 0.34) of males with M-R versus sensitive strains, respectively. Twelve patients (5 %) had to stop treatment prematurely because of severe side effects, but eight of them were treated successfully. One case of H. pylori infection (0.6 %) was detected at 1-yr follow-up. CONCLUSIONS: Ten-day bismuth triple therapy t.i.d. was effective in curing H. pylori infection in the context of routine clinical practice. The efficacy was reduced in females harboring M-R strains.

Adult

A cap 'n' collar protein isoform contains a selective Hox repressor function.

We have characterized a protein isoform (CncB) from the Drosophila cap 'n' collar locus that selectively represses cis-regulatory elements that are activated by the Hox protein Deformed. Of the three Cnc protein isoforms, CncB is expressed in a localized pattern in mandibular and labral cells of the head during mid-stages of embryogenesis. When CncB protein is absent or reduced, mandibular cells are homeotically transformed toward maxillary identities. This transformation is associated with persistent Deformed expression in anterior mandibular cells, since the Deformed autoactivation circuit is normally antagonized by CncB function in these cells. Heat-shock-induced ectopic expression of CncB in mid-stages of embryogenesis is sufficient to attenuate the activity of Dfd response elements in maxillary epidermal cells, but appears to have no effect in trunk epidermal cells on either the function or the response elements of other Hox proteins. CncB provides a mechanism to modulate the specificity of Hox morphogenetic outcomes, which results in an increase in the segmental diversity in the Drosophila head.

Amino Acid Sequence

Solid phase technology improves coupled gel shift/footprinting analysis.

For the analysis of protein-DNA interactions by coupled gel-shift/footprinting, DNA fragments need to be extracted from polyacrylamide gels and subsequently separated on high resolution gels. Due to impurities in the extracted DNA, single nucleotide resolution is frequently not achieved. We now describe an improved experimental strategy that employs transient coupling of DNA fragments to a solid support in order to extract DNA of high purity quantitatively, rapidly and reliably. As an example, we describe the application of our protocol to the 'in-gel footprinting' by copper phenanthroline. The method should also find application to the chemical interference assays.

Bacterial Proteins

A comparison between omeprazole-based triple therapy and bismuth-based triple therapy for the treatment of Helicobacter pylori infection: a prospective randomized 1-yr follow-up study.

OBJECTIVES: To compare the efficacy and side effects of standard bismuth triple therapy with those of omeprazole-based triple therapy in patients with Helicobacter pylori infection and duodenal ulcer disease. METHODS: One hundred patients were prospectively recruited and randomized to receive either bismuth subnitrate 75 mg q.i.d., oxytetracycline 500 mg q.i.d., and metronidazole 400 mg b.i.d. (regimen BTM), or omeprazole 20 mg b.i.d., amoxicillin 750 mg b.i.d., and metronidazole 400 mg b.i.d. (regimen OAM), both for 14 days. Upper endoscopy (with antral biopsy specimens for microbiology and antral and corpus biopsy specimens for histology) was performed before treatment, after 2 months, and again 1 yr after treatment. Serum samples for serology (IgG) were taken. Patients with in vitro metronidazole-resistant (M-R) H. pylori strains were excluded. In a nonrandomized study, 41 patients with M-R strains were given either BTM or OAM. RESULTS: According to intention-to-treat analysis, H. pylori cure rates were 91% and 96% with BTM and OAM, respectively (p = 0.45). In the BTM group, the mean total side effect score was higher (p < 0.001), and more severe side effects were reported (32% vs. 4%, p < 0.001). In the nonrandomized group of patients with M-R strains, H. pylori cure rates were 88% and 67% with BTM and OAM, respectively. All of the successfully treated patients were still H. pylori-negative after 1 yr. CONCLUSIONS: Both treatment regimens were highly effective in curing H. pylori infection in patients with metronidazole-sensitive strains. Omeprazole-based triple therapy was tolerated better than standard bismuth-based triple therapy.

Adult

[Diagnosis of Chlamydia trachomatis--culture or enzyme immunoassay? Norwegian multicenter study].

Two EIA-tests (Chlamydiazyme, Abbott and Ideia, Celltech) were compared with culture for diagnosis of chlamydial infection in 1,185 patients from four different regions in Norway. The EIA-tests showed only minor differences in prevalences between the different regions (Chlamydiazyme: 4.1% to 5.4%; Ideia: 5.1% to 5.7%), but the agreement between the EIA-results was not satisfactory. 4.6 per cent of the specimens from Trondheim were culture-positive, but only 2.0% of the specimens from the other regions were culture-positive. Compared with the results from cultures from Trondheim (n = 349), the sensitivity, specificity, positive and negative predictive values for the EIA-tests were: Chlamydiazyme: 81.3%, 98.2%, 68.4% and 99.1% (81.3%, 96.4%, 52.0% and 99.1% without blocking test); Ideia: 93.8%, 98.5%, 75.0% and 99.7%. Culture should not be used as a routine method for detection of chlamydia in specimens sent by post without cooling.

Bacteriological Techniques

Congenital malaria in Scandinavia.

A case of Plasmodium vivax malaria in a 3-week-old infant, born in Norway of a Pakistanian mother, is reported. The child was admitted with a febrile illness of unknown origin, persistent vomiting, reduced body weight, thrombocytopenia, elevated total level of IgM, and a slightly positive specific IgG antibody titer. The mother had malaria during the puerperium, and febrile episodes 6-8 weeks before parturition. This is the first case of congenital malaria reported from Scandinavia.

Adult

The comparative in vitro activity of spiramycin and erythromycin against Norwegian bacterial isolates.

The in vitro activity of spiramycin and erythromycin has been determined by an agar diffusion method against relevant clinical isolates. Generally, erythromycin was more active than spiramycin on a weight-for-weight basis. Spiramycin showed only moderate activity against Haemophilus influenzae and Streptococcus pyogenes. Gonococci were sensitive in vitro to both agents. Many erythromycin-resistant staphylococci were sensitive to spiramycin.

Bacteria

Endocarditis caused by Pasteurella multocida.

A 51-year-old previously healthy man developed endocarditis with low grade fever, aortic insufficiently and multiple arterial emboli. An atypical strain of Pasteurella multocida was isolated from each of 3 consecutive blood cultures. Protracted treatment with high doses of penicillin G was necessary to eradicate the infection. Following resection of the damaged aortic valves and implantation of a valve prosthesis, the patient recovered. P. multocida should be regarded as one of the possible causes of subacute bacterial endocarditis.

Aortic Valve

Neonatal osteomyelitis caused by group B streptococci.

A 3-week-old infant with a group B streptococcal osteomyelitis is described. On admission swelling and fluctuation were combined with local erythema in the right ankle joint region. Group B streptococci, type Ib, were isolated both from blood and from the local focus in the ankle. The diagnosis was further confirmed by X-ray examination showing a lytic lesion in the talus. The child was successfully treated with penicillin, initially in combination with kanamycin.

Ankle Joint