AIM:To evaluate the influence of multiple samplings during esophagogastr oduodenoscopy(EGD) on the accuracy of the rapid urease test,and the validity of newly developed rapid urease tests,HelicotecUT plus test and Hel...AIM:To evaluate the influence of multiple samplings during esophagogastr oduodenoscopy(EGD) on the accuracy of the rapid urease test,and the validity of newly developed rapid urease tests,HelicotecUT plus test and HelicotecUT test,CLO test and ProntoDry test.METHODS:A total of 355 patients undergoing EGD for dyspepsia were included.Their Helicobacter pylori(H.pylori) treatment status was either nave or eradicated.Six biopsy specimens from antrum and gastric body,respectively,were obtained during EGD.Single antral specimens and dual(antrum+body) specimens were compared.Infection status of H.pylori was evaluated by three different tests:culture,histology,and four different commercially available rapid urease tests(RUTs)-including the newly developed HelicotecUT plus test and HelicotecUT test,and established CLO test and ProntoDry test.H.pylori status was defined as positive when the culture was positive or if there were concordant positive results among histology,CLO test and ProntoDry test.RESULTS:When dual specimens were applied,sensitivity was enhanced and RUT reaction time was signif icantly reduced,regardless of their treatment status.Thirty minutes were enough to achieve an agreeable positive rate in all the RUTs.Both newly developed RUTs showed comparable sensitivity,specif icity and accuracy to the established RUTs,regardless of patient treatment status,RUT reaction duration,and EGD biopsy sites.CONCLUSION:Combination of antrum and body biopsy specimens greatly enhances the sensitivity of rapid urease test and reduces the reaction duration to 30 min.展开更多
Prehabilitation for abdominal wall procedures provides an opportunity to further modify patient risk factors for surgical complications.It includes interventions that optimize nutrition,glycemic control,functional sta...Prehabilitation for abdominal wall procedures provides an opportunity to further modify patient risk factors for surgical complications.It includes interventions that optimize nutrition,glycemic control,functional status,and utilization of the patient's microbiome pre-,intra-,and postoperatively.Through a multidisciplinary and anticipatory approach to patients'existing co-morbidities,the physiological stress of surgery may be attenuated to ultimately minimize perioperative morbidity in the elective setting.With increasing data to support the efficacy of prehabilitation in optimizing surgical outcomes and decreasing hospital length of stay,it is incumbent on the surgeon to employ these practices in elective abdominal wall reconstruction.Further research on the effects of prehabilitation interventions will help to shape and inform protocols that may be implemented beyond abdominal wall procedures in an effort to continually improve best practices in surgical care.展开更多
基金Supported by A Grant from Kaohsiung Medical University Hospital (M094015, 94-KMUH-032, KMUH95-5D51)E-Da Hospital (EDAH-D-97(P)014A)+1 种基金Excellence for cancer research center grant, No DOH99-TD-C-111-002Department of Health, Executive Yuan, Taiwan
文摘AIM:To evaluate the influence of multiple samplings during esophagogastr oduodenoscopy(EGD) on the accuracy of the rapid urease test,and the validity of newly developed rapid urease tests,HelicotecUT plus test and HelicotecUT test,CLO test and ProntoDry test.METHODS:A total of 355 patients undergoing EGD for dyspepsia were included.Their Helicobacter pylori(H.pylori) treatment status was either nave or eradicated.Six biopsy specimens from antrum and gastric body,respectively,were obtained during EGD.Single antral specimens and dual(antrum+body) specimens were compared.Infection status of H.pylori was evaluated by three different tests:culture,histology,and four different commercially available rapid urease tests(RUTs)-including the newly developed HelicotecUT plus test and HelicotecUT test,and established CLO test and ProntoDry test.H.pylori status was defined as positive when the culture was positive or if there were concordant positive results among histology,CLO test and ProntoDry test.RESULTS:When dual specimens were applied,sensitivity was enhanced and RUT reaction time was signif icantly reduced,regardless of their treatment status.Thirty minutes were enough to achieve an agreeable positive rate in all the RUTs.Both newly developed RUTs showed comparable sensitivity,specif icity and accuracy to the established RUTs,regardless of patient treatment status,RUT reaction duration,and EGD biopsy sites.CONCLUSION:Combination of antrum and body biopsy specimens greatly enhances the sensitivity of rapid urease test and reduces the reaction duration to 30 min.
文摘Prehabilitation for abdominal wall procedures provides an opportunity to further modify patient risk factors for surgical complications.It includes interventions that optimize nutrition,glycemic control,functional status,and utilization of the patient's microbiome pre-,intra-,and postoperatively.Through a multidisciplinary and anticipatory approach to patients'existing co-morbidities,the physiological stress of surgery may be attenuated to ultimately minimize perioperative morbidity in the elective setting.With increasing data to support the efficacy of prehabilitation in optimizing surgical outcomes and decreasing hospital length of stay,it is incumbent on the surgeon to employ these practices in elective abdominal wall reconstruction.Further research on the effects of prehabilitation interventions will help to shape and inform protocols that may be implemented beyond abdominal wall procedures in an effort to continually improve best practices in surgical care.
