Capillaria hepatica causes two main lesions in the liver of rats: multifocal chronic inflammation, directly related to the presence of disintegrating parasites and their eggs, and a process of systematized septal fibrosis. The comparative behavior of these two lesions was investigated in rats experimentally infected with 600 embryonated eggs, following either corticosteroid treatment or specific antigenic stimulation, in an attempt to understand the relationship between these two lesions, and the pathogenesis of septal fibrosis. The two treatments differently modified the morphological aspects of the focal parasitic-related lesions, but did not interfere with the presentation of diffuse septal fibrosis, although a mild decrease in the degree of fibrosis occurred in corticoid-treated animals. These findings indicate that although the two lesions are C. hepatica induced, they are under different pathogenetic control, the induction of septal fibrosis being triggered during early infection to follow an independent pathway.

O H. pylori está presente no estômago da maioria dos pacientes portadores de úlcera duodenal. Para seu diagnóstico são utilizados: técnicas de histopatologia, o teste da urease e testes respiratórios (UBT) com uréia marcada com o isótopo radioativo (14C) ou do estável (13C). Este trabalho teve por objetivos: 1) realizar o UBT como procedimento diagnóstico da presença de H. pylori utilizando isótopo estável; 2) comparar os resultados com os obtidos por meio da urease, histologia (considerados padrão-ouro) e UBT com 14C-uréia. Foram avaliados 54 pacientes com idades entre 30 e 55 anos, sendo 25 mulheres. O UBT apresentou sensibilidade e especificidade 90% (Kappa entre 0,77 e 1,03). Níveis de detecção, aos 30 minutos, menores que 4,82d‰ foram considerados negativos. Entre 4,82 e 14,96d‰, duvidosos, recomendando repetir o teste, e acima deste valor, positivos. Neste estudo, o UBT com 13C-uréia foi prático, adequado, de fácil execução e inócuo, recomendando este procedimento diagnóstico na suspeita da presença do H. pylori em adultos e crianças, independente do sexo ou condição fisiopatológica.

Helicobacter pylori is found in the stomach of most patients with duodenal ulcer. Techniques for its diagnosis include histopathology, urease test and urea breath test (UBT) using urea labeled with radioactive (14C) or stable carbon (13C). The objectives of the present study were: 1) to carry out UBT for the diagnosis of H. pylori using a stable isotope; 2) to compare the results with those obtained by the urease test, histology (considered to be the gold standard), and 14C UBT. Fifty-four patients (25 women) aged 30 to 55 years were studied. The UBT showed 90% sensitivity and specificity (Kappa value ranging from 0.77 to 1.03). Detection levels at 30 min below 4.82d‰ were considered to be negative. Values between 4.82 and 14.96d‰ were considered to be doubtful, with repetition of the test being recommended in these cases, while levels above this value were considered to be positive. The 13C UBT was found to be practical, adequate, easy to carry out and harmless, thus being recommended as a diagnostic procedure for adults and children with suspected H. pylori infection, irrespective of sex or pathophysiological condition.

CONTEXTO: O desenvolvimento de técnicas simples, acuradas e de baixo custo para a detecção da infecção do Helicobacter pylori tem grande interesse. OBJETIVO: Determinar a acurácia de um teste respiratório rápido (UBT) que emprega dispositivo simples para coleção do ar expirado. TIPO DE ESTUDO: Estudo prospectivo. LOCAL: Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto. PARTICIPANTES: 137 pacientes adultos que realizaram endoscopia digestiva alta no HCFMRP e consentiram em participar da pesquisa. VARIÁVEIS ESTUDADAS: Histologia e teste da urease, UBT. Variáveis estudadas: sensibilidade e especificidade do UBT. RESULTADOS: 115 pacientes estavam infectados pelo HP conforme os resultados tanto da histologia como do teste da urease e 22 eram negativos para HP de acordo com os mesmos testes. O UBT discriminou claramente esses dois grupos, e quando a combinação de histologia e teste da urease foi tomada como "gold standard" para infecção pelo HP, a especificidade e a sensibilidade do UBT foram superiores a 90% para diferentes pontos de corte e momentos de coleta do ar expirado. CONCLUSÃO: UBT rápido tem elevada acurácia para a infecção pelo HP.

CONTEXT: The development of simple, accurate and low-expense techniques for detection of Helicobacter pylori infection has great relevance. OBJECTIVE: To determine the accuracy of a rapid 14C-urea breath test (UBT) employing a very simple device for breathed air collection. DESIGN: Prospective study. SETTING: Hospital das Clinicas of the Faculty of Medicine of Ribeirão Preto. PARTICIPANTS: One hundred and thirty-seven adult patients who underwent upper gastrointestinal endoscopy in the Clinical Hospital. MAIN MEASUREMENTS: Histology for Helicobacter pylori (HP); urease test; urea breath test (UBT). RESULTS: One hundred and fifteen patients were infected by HP (HP+) according to both histology and the urease test, and 22 patients were HP-negative (HP-), according to the same two tests. UBT was capable of discriminating between HP+ and HP- in a way that was similar to the combination of urease test and histology. When this combination of results is taken as the "gold standard" for HP infection, the sensitivity and specificity of UBT are both greater than 90% for a range of cut-off points and breathed air collection times. CONCLUSION: The rapid UBT employing a simple device for air collection has a high accuracy in determining HP infection.