CONTEXT: The role of serologic testing to confirm cure of Helicobacter pylori infection after antimicrobial therapy is not completely defined. OBJECTIVE: To determine the utility of serologic testing in confirming cure of H pylori infection more than 1 year after therapy. DESIGN: A prospective, before-after interventional trial. SETTING: An outpatient clinical research laboratory in an academic, urban Veterans Affairs medical center. PARTICIPANTS: Twenty-three otherwise healthy men and women with active H pylori infection demonstrated by gastric biopsy and with positive H pylori serologic findings. INTERVENTION: A 14-day course of bismuth, tetracycline, and metronidazole. MAIN OUTCOME MEASURES: Determination of IgG serum antibodies to H pylori at baseline, 1 month, 3 months, and approximately 18 months after completion of therapy compared with serial gastric mucosal biopsy specimens with stains for H pylori and for histologic examination as the criterion standard. RESULTS: Fifteen (65%) of 23 subjects were cured of their H pylori infection as assessed by gastric biopsy, with elimination of gastritis; median antibody levels declined from 92.5 U/mL at baseline to undetectable levels at 18 months. The other 8 subjects (35%) were not cured and had persistent gastritis at 18 months; median antibody levels declined from 130.6 U/mL at baseline to 89.7 U/mL at 18 months. Sensitivity and specificity of seroconversion (from a positive to negative test result) in detecting cure of H pylori infection were 60% and 100%, respectively. CONCLUSION: Undetectable antibody levels beyond the first year of therapy accurately confirm cure of H pylori infection in initially seropositive healthy subjects, with reasonable sensitivity.

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Comparison of two assays (EIA and EITB) and two samples (saliva and serum) for the diagnosis of neurocysticercosis.

The enzyme immunoassay (EIA), standardized with a crude extract, and the enzyme-linked immunoelectrotransfer blot assay (ETIB) with glycoprotein antigens, were compared by using saliva and serum in the search for specific antibodies against Taenia solium larvae, for the diagnosis of neurocysticercosis. Saliva was slightly more sensitive in EIA (82.1%) than serum (74.1%). In EITB serum was far more sensitive (100%) than saliva (70.4%). The use of EITB with serum is thus an excellent choice for diagnosis of clinical cases of neurocysticercosis, while EIA using saliva represents a useful combination for diagnosis and, especially, epidemiology, because saliva is easily obtained by a painless and non-invasive procedure and the technique is simpler to perform. Furthermore, cross-reactivity of EIA with Echinococcus does not interfere in countries like Mexico where human hydatid disease is not present.

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Symptoms of sexual dysfunction and depression in diabetic women.

Studies of sexual dysfunction in diabetic women have been less conclusive than those of sexual dysfunction in diabetic men. We examined the relationship between symptoms of sexual dysfunction, neuropathy, and depression in diabetic women. Diabetic women with neuropathy experienced significantly more symptoms of sexual dysfunction and depression than diabetic women without neuropathy. Furthermore, among women with neuropathy, there was a significant positive correlation between the degree of sexual dysfunction experienced and the degree of depression. These results indicate that depressive symptoms should be examined in studies of sexual dysfunction in diabetic women, and that a biopsychosocial approach is best for assessing sexual dysfunction in diabetic women.

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Uterine and tubal transplantation.

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