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M Veselic

Publications and source records attributed to M Veselic.

6 recordsLinked to original sources
PubMed1995

Diagnosis of Helicobacter pylori infection by specific gastric mucosal IgA and IgG pylori antibodies.

AIMS: To investigate the diagnostic value of mucosal IgA and IgG Helicobacter pylori antibodies. METHODS: The study population comprised 209 consecutive patients with severe dyspeptic complaints referred for upper gastrointestinal endoscopy. A positive culture or histological identification of H pylori in gastric biopsy specimens, or both, were used to confirm infection. Specific IgA and IgG H pylori antibodies were determined using a modified ELISA technique. RESULTS: Of the 209 patients, 137 were infected with H pylori. The diagnostic value of systemic IgA and IgG H pylori antibodies was confirmed. Systemic IgA antibodies had a sensitivity of 76.6% (95% confidence interval 69.5-83.7) and a specificity of 94.4% (89.1-99.7). The sensitivity and specificity for systemic IgG antibodies were, respectively, 97.1% (94.3-99.9) and 98.6% (95.9-100). A moderate but clinically important correlation was found between local and systemic IgA and IgG. Mucosal IgA H pylori antibodies had a sensitivity of 98.5% (96.5-100) and a specificity of 91.7% (85.3-98.1), while for IgG these figures were, respectively, 88.3% (82.9-93.7) and 98.6% (95.9-100). As a diagnostic test mucosal IgA H pylori antibodies were comparable with culture and histology. CONCLUSION: Determination of local IgA and IgG H pylori antibody levels is a highly sensitive and specific test for the diagnosis of H pylori infection.

Adult↗
PubMed1995

Triple therapy with ranitidine, clarithromycin, and metronidazole in the treatment of Helicobacter pylori.

BACKGROUND: To determine whether a triple therapy regimen for the treatment of Helicobacter pylori infection, consisting of ranitidine 300 mg q.i.d., clarithromycin 500 mg t.i.d., and metronidazole 500 mg t.i.d. would provide a safe and effective treatment regimen, we performed an open prospective study in 20 consecutive patients with proven H. pylori-associated non-ulcer dyspepsia or peptic ulcer disease. METHODS: The percentage of patients in whom eradication of H. pylori succeeded was determined. A semiquantitative assessment of histology was performed, and the results were analysed using Wilcoxon's matched-pairs ranks tests; side effects were noted and graded. RESULTS: Eradication was achieved in 19 of 20 patients, i.e. in 95% (confidence interval 85-100%). Eradication of the bacterium led to a significant improvement in semiquantitative histology scores; active antral inflammation decreased from (mean +/- SEM) 1.84 +/- 0.19 to 0.21 +/- 0.16 (p = 0.0004) and chronic antral inflammation from 2.47 +/- 0.14 to 1.16 +/- 0.14 (p = 0.0002); active gastric body inflammation decreased from 0.95 +/- 0.19 to 0.00 +/- 0.00 (p = 0.0015) and chronic inflammation from 1.68 +/- 0.17 to 0.32 +/- 0.11 (p = 0.0007). Side effects occurred in 45% of patients, but in over half of these patients only mild side effects occurred. Severe side effects did not occur, none of the patients discontinued the triple therapy. CONCLUSIONS: Triple therapy with ranitidine, clarithromycin, and metronidazole provides a safe and effective treatment of H. pylori infection, resulting in a high eradication rate, and in significant decrease in semiquantitative histology scores. Further prospective studies are warranted.

Adult↗
PubMed1995

Serum gastrin and mucosal somatostatin in Helicobacter pylori-associated gastritis.

AIMS: The aims were to study gastrin concentrations and gastric mucosal somatostatin and gastrin concentrations in relation to the extent of gastritis in Helicobacter infection. METHODS: We measured basal serum gastrin concentrations in antral mucosal biopsy specimens and somatostatin concentrations in corpus biopsy specimens in 88 consecutive dyspeptic subjects undergoing endoscopy. These subjects were divided into three categories on the basis of histology, serology, and culture: H. pylori-positive pangastritis, H. pylori positive antral gastritis with normal body histology, and H. pylori-negative controls. Statistical evaluation was done with the Wilcoxon rank sum test. RESULTS: Basal serum gastrin concentrations were significantly increased only in subjects with pangastritis and not in those with antral gastritis only, as compared with controls (mean +/- SEM: 72 +/- 7, 46 +/- 10, and 42 +/- 7 ng/l, respectively). Subjects with pangastritis or antral gastritis had significantly lower antral somatostatin concentrations than controls (mean +/- SEM: 0.80 +/- 0.07, 1.03 +/- 0.15, and 2.40 +/- 0.31 micrograms/g(protein), respectively). We also found significantly lower antral gastritis only as compared with controls (mean +/- SEM: 62 +/- 13, 78 +/- 16, and 165 +/- 25 micrograms/g(protein), respectively). In subjects with pangastritis a significantly lower concentration of somatostatin was found in the corpus biopsy specimens than in those with antral gastritis only and controls. CONCLUSIONS: These results suggest that hypergastrinemia in H. pylori gastritis is not caused by antral gastritis and antral somatostatin deficiency alone but that corpus inflammation plays a key role in the origin of hypergastrinemia. Furthermore, in patients with pangastritis a corpus mucosal somatostatin deficiency was found.

Adolescent↗
PubMedDate not supplied

Preoperative diagnostic tests for operable thyroid disease.

Although the availability and acceptance of fine-needle aspiration biopsy (FNAB) of thyroid nodules has increased, many physicians still use thyroid scintigraphy for distinguishing benign from malignant lesions. We evaluated these diagnostic tests in 350 patients who had thyroid surgery in our institution between 1977 and 1990. Histologic confirmation of FNAB was obtained in 265 patients. In the group of patients having surgery, 247 thyroid scintigraphies were performed. Our patients were divided into two groups (1977-1986 and 1986-1990). The first group comprised 173 patients with 173 FNABs and 126 scintigrams. The second group consisted of 177 patients having 92 FNABs and 121 scintigrams. Results of scintigrams were analyzed in the second group only. In 5 out of 120 cases where the FNAB result was "benign or probably benign" the lesion appeared to be malignant postoperatively. If the FNAB result was "malignant or probably malignant" (n = 83) the pathology report confirmed a malignancy in 68 cases (81.9%). In 56 instances of all 265 FNABs the cytology report was not conclusive ("uncertain"); in 21.4% of these cases a malignancy was found postoperatively. An FNAB-result "(probably) malignant" had a positive predictive value of 0.819 while the negative predictive value of a result "(probably) benign" is 0.950. An "uncertain" result does not take away our concern so this result should have the same consequences as those of a result "(probably) malignant". In that case, FNAB-sensitivity is 93.0% and specificity 66.1%. Eighty-five of the last 116 scintigraphies showed a solitary node. Eleven of these nodes were hot while 74 were cold.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗