PubMed · 3798893
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V N Korotkiĭ, N Ia Kalita, G G Roshchin, V A Gaevskaia, A N Sova. 1986. [Method for diagnosing jaundice].. https://pubmed.ncbi.nlm.nih.gov/3798893/
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In the present paper optical fibre sensors for the detection of foregut diseases are described, in particular, sensors for the detection of bile, carbon dioxide and pH. Bile-containing refluxes are measured by means of a sensor which uses bilirubin as natural marker. The sensor, which is already present on the market, has been clinically validated by various hospitals. The clinically relevant parameter is the exposure time of the stomach/oesophagus mucosa to the bile. When measured in the oesophagus, it has been shown to be closely correlated with the onset of Barrett's oesophagus or general oesophagitis. Recently, optical fibres have been proposed for the continuous monitoring of carbon dioxide in the stomach: an important parameter in critically ill patients. A clinically validated prototype has shown its superiority in comparison with the traditional method, that is based on gastric tonometry. For the sake of completeness, also gastric pH sensors are considered, although at the moment their development is stationary at the laboratory stage.
Helicobacter pylori is one of the most prevalent human pathogens in the world and is the aetiological agent of gastritis, peptic ulcer disease and gastric malignancies. In addition H. pylori and other novel members of the genus are capable of successfully colonising the bile-rich niche of the upper intestine and are associated with a diverse range of intestinal pathologies. Surface-enhanced laser desorption/ionisation-time of flight mass spectrometry was used to analyse surface extracts from H. pylori, Helicobacter bilis, Helicobacter pullorum and "Helicobacter sp. flexispira" to characterise cell surface changes following bile stress. The system detected two distinct response patterns to bile stress on the cell surface of Helicobacter spp. in vitro. The first involved the increase under bile stress of peaks at 7.6 and 7.9 kDa for H. billis and H. pullorum, respectively. In contrast both "Helicobacter sp. flexispira" and a clinical isolate of H. pylori had similar response profiles to bile stress. Both strains had at least three low mass peaks decreased under bile stress and a single peak induced by bile stress. The present study has established the use of ProteinChip(R) technology to analyse helicobacter-related proteomics. Specifically this study has established that different patterns are generated in response to bile stress among various pathogenic Helicobacter spp. which may give insights into the ability of these strains to colonise different niches.
Biliary sludge develops commonly in critically ill patients and may be associated with biliary colic, acute pancreatitis or acute cholecystitis. Sludge often resolves upon resolution of the underlying pathogenetic factor. It is generally diagnosed on sonography. Treatment of sludge itself is unnecessary unless further complications develop. Acute acalculous cholecystitis also develops frequently in critically ill patients. It may be difficult to diagnose in these patients, manifesting only as unexplained fever, leukocytosis or sepsis. Sonography and hepatobiliary scintigraphy are the most useful diagnostic tests. Management decisions should take into account the underlying co-morbid conditions. For many patients, percutaneous cholecystostomy may be the best management option. Cholecystostomy may also provide definitive drainage as patients recover and underlying critical illness resolves.