Comparison of three stool antigen tests in confirming Helicobacter pylori eradication in adults

OBJECTIVE: Reliable and readily available non-invasive methods are needed for detection of Helicobacter pylori infection and assessment of eradication therapy. In H. pylori-positive subjects we compared three stool antigen tests (Premier Platinum HpSA, Amplified IDEIA HpStAR and ImmunoCard STAT!HpSA) with invasive tests before their eradication therapy, and with non-invasive diagnostic methods after their therapy. MATERIAL AND METHODS: A total of 82 adults with dyspepsia (aged 24-79 years) with an H. pylori-positive rapid urease test were enrolled in the study. Before therapy, H. pylori status was also confirmed with histology, culture and serology. After eradication, success was assessed with the [13C]-urea breath test (UBT) and usually also with serology. RESULTS: At baseline, sensitivities of these stool antigen tests were 90.2% for HpSA, 97.6% for HpStAR and 96.3% for ImmunoCard. Eradication therapy was successful in 66 patients and unsuccessful in 16. Sensitivity and specificity of the three stool antigen tests in the post-eradication setting were, respectively, 75.0% and 95.5% for HpSA, 93.8% and 98.5% for HpStAR and 87.5% and 95.5% for Immunocard. CONCLUSIONS: The performance of all three stool antigen tests in the post-treatment setting was slightly inferior to that of the UBT test and serology, with monoclonal antibody-based tests showing better results.     

Use of the levonorgestrel-releasing intrauterine system and breast cancer

OBJECTIVE: The effect of exogenous hormones on the incidence of breast cancer has been extensively studied. Most studies regarding hormonal contraception have focused on combined oral contraceptives, and there is paucity of literature regarding nonoral and progestin-only contraceptives. The present study analyzed the relationship between breast cancer and use of the levonorgestrel-releasing intrauterine system. METHODS: This study was based on data gathered from a large postmarketing study on levonorgestrel-releasing intrauterine system users (n = 17,360) carried out in Finland. The results present an incidence comparison between levonorgestrel system user data and the data on average Finnish female population (derived from the Finnish Cancer Registry), between 30 and 54 years of age. RESULTS: Based on the 95% confidence intervals for the incidences of breast cancer, and the Fisher exact test, there is no indication of a difference between the levonorgestrel system users and average Finnish female population in any of the 5-year age groups. The incidence rate per 100,000 woman-years was for the age groups 30-34 years 27.2 and 25.5, for 35-39 years 74.0 and 49.2, for 40-44 years 120.3 and 122.4, for 45-49 years 203.6 and 232.5, and for 50-54 years 258.5 and 272.6, in the levonorgestrel system group and in Finnish female population, respectively. CONCLUSION: The results suggest that the use of the levonorgestrel-releasing intrauterine system is not associated with an increased risk of breast cancer.     

Microbial exposure and mold-specific serum IgG levels among children with respiratory symptoms in 2 school buildings

In this study, the authors determined the association between serum mold-specific immunoglobulin G (IgG) levels in primary school children (N = 181) with asthma, wheezing, or cough symptoms and exposure to indoor mold in 2 schools, with and without mold damage. Microbial exposure was determined with environmental sampling. Serum IgG antibody concentrations against 24 microbial strains were determined with enzyme-linked immunosorbent assay. Children's microbe-specific IgG levels were often higher in the reference school. There was an association between elevated serum IgG antibody levels to Penicillium notatum and moisture damage in the school. In addition, moisture damage both in school and at home was associated with Penicillium notatum and Eurotium amstelodami IgG levels. These observations comported with microbial findings in the index school. No other positive associations between IgG antibodies and microbial findings for the school buildings were observed. IgG levels in sera of school children did not provide a specific means for assessing the microbial exposure associated with moisture and microbial problems in the school buildings. Thus, IgG analysis cannot be readily suggested as a routine method for the evaluation of these exposures.     

Production of proinflammatory mediators by indoor air bacteria and fungal spores in mouse and human cell lines

We compared the inflammatory and cytotoxic responses caused by household mold and bacteria in human and mouse cell lines. We studied the fungi Aspergillus versicolor, Penicillium spinulosum, and Stachybotrys chartarum and the bacteria Bacillus cereus, Pseudomonas fluorescens, and Streptomyces californicus for their cytotoxicity and ability to stimulate the production of inflammatory mediators in mouse RAW264.7 and human 28SC macrophage cell lines and in the human A549 lung epithelial cell line in 24-hr exposure to 10(5), 10(6), and 10(7) microbes/mL. We studied time dependency by terminating the exposure to 10(6) microbes/mL after 3, 6, 12, 24, and 48 hr. We analyzed production of the cytokines tumor necrosis factor-alpha and interleukins 6 and 1ss (TNF-alpha, IL-6, IL-1ss, respectively) and measured nitric oxide production using the Griess method, expression of inducible NO-synthase with Western Blot analysis, and cytotoxicity with the MTT-test. All bacteria strongly induced the production of TNF-alpha, IL-6 and, to a lesser extent, the formation of IL-1ss in mouse macrophages. Only the spores of Str. californicus induced the production of NO and IL-6 in both human and mouse cells. In contrast, exposure to fungal strains did not markedly increase the production of NO or any cytokine in the studied cell lines except for Sta. chartarum, which increased IL-6 production somewhat in human lung epithelial cells. These microbes were less cytotoxic to human cells than to mouse cells. On the basis of equivalent numbers of bacteria and spores of fungi added to cell cultures, the overall potency to stimulate the production of proinflammatory mediators decreased in the order Ps. fluorescens > Str. californicus > B. cereus > Sta. chartarum > A. versicolor > P. spinulosum. These data suggest that bacteria in water-damaged buildings should also be considered as causative agents of adverse inflammatory effects.     

Strontium plaque irradiation of subfoveal neovascular membranes in age-related macular degeneration

• Purpose: To determine the effect of focal strontium-90 plaque radiotherapy on subfoveal choroidal neovascularization in patients with age-related macular degeneration. • Methods: Twenty patients with age-related macular degeneration, presenting with a recent subfoveal neovascular membrane, were treated with local episcleral radiotherapy using a strontium-90 applicator. The applicator was applied to the sciera under the macular region and held there tightly for 54 min to obtain a dose of 15 Gy at a depth of 1.75 mm. The main parameters evaluated at follow-up after 3, 6 and 12 months were visual acuity and changes in fluorescein angiography. Twelve untreated patients with the same criteria were followed as controls. • Results: Early effects of radiation could be seen at 3 months, but became more obvious after follow-up for 6 and 12 months. At 6 months, regression of the choroidal neovascularization was detected in 14/19 patients (74%) as a decrease in the size of the lesion or as diminished leakage in late-phase fluorescein angiography. Likewise, in 14/19 patients (74%) at 12 months the neovascular membrane was partially or totally occluded. In all patients showing regression of the choroidal neovascular membrane, the neurosensory detachment had also dried. Visual acuity was unchanged (within 1 line) or improved in 11/20 (55%) and 9/20 (45%) treated patients after 6 and 12 months, respectively. In the controls, the choroidal neovascularization had increased in size in 9/12 patients (75%) at the last follow-up (mean 12.0 months). Visual acuity was unchanged in 3/12 patients (25%). • Conclusion: Local low-energy beta irradiation with a strontium-90 applicator can induce regression of choroidal neovascularization. The effect of irradiation is seen as a decrease in the size of the choroidal neovascular membrane and disappearance of the neurosensory detachment and exudates. Presented in part at the ARVO Annual Meeting, Fort Lauderdale, May 1995 and at the XX meeting of the Club Jules Gonin, Bern, September 1996     

Intoxicating effects of three aliphatic alcohols and barbital on two rat strains genetically selected for their ethanol intake

Intoxicating effects of ethanol, isopropanol, tert. butanol and barbital were studied by comparing performances on the tilted plane of ethanol preferring AA (Alko, Alcohol) and ethanol avoiding ANA (Alko, Non-Alcohol) rat strains raised by genetic selection for their voluntary ethanol intake. The motor coordination of AA rats was found to be less affected than that of ANA rats by all three alcohols and barbital. The results indicate a marked genetic difference in neural tolerance to the alcohols and barbital, and suggest that neural tolerance to alcohols plays a role in determining the ethanol preference of AA rats and ethanol aversion of ANA rats.     

Metabolic syndrome aggravates the increased endothelial activation and low‐grade inflammation in subjects with familial low HDL

Background. Inhibition of cytokine‐induced expression of adhesion molecules is one of the atheroprotective mechanisms of high‐density lipoprotein (HDL).

Aim. We investigated whether increased endothelial activation and low‐grade inflammation are present in Finnish subjects with familial low HDL, and which factors contribute to the inflammatory parameters.

Method. High‐sensitivity C‐reactive protein (hsCRP), soluble intercellular adhesion molecule‐1 (sICAM‐1), vascular cell adhesion molecule‐1 (sVCAM‐1), and sE‐selectin were measured in 91 subjects with low HDL‐cholesterol from 41 low‐HDL families and in 112 normolipidemic controls with comparable age‐ and gender distribution. Presence of the features of the metabolic syndrome (MetS) was recorded.

Results. sVCAM‐1, sICAM‐1, sE‐selectin, and hsCRP were significantly higher in low‐HDL subjects than in the controls (sVCAM‐1: 560±147?ng/mL versus 496±95?ng/mL, P = 0.001; sICAM‐1: 247±60?ng/mL versus 215±47?ng/mL, P<0.001; sE‐selectin: 52±20?ng/mL versus 44±16?ng/mL, P = 0.022; and hsCRP: 1.73±2.05?mg/L versus 0.85±1.10?mg/L, P<0.001). Low‐HDL subjects had increased body mass index (BMI) and waist, and elevated insulin and triglyceride levels. Adhesion molecules and hsCRP increased according to the number of the features of the MetS.

Conclusions. The presence of the MetS in subjects with familial low HDL‐cholesterol aggravates the low‐grade inflammation and endothelial activation, and ultimately may add to the higher susceptibility for atherosclerotic disease in these individuals.