Magnesium hydrogen breath test using end-expiratory sampling to assess achlorhydria in pernicious anaemia patients

A modified magnesium hydrogen breath test, using end expiratory breath sampling, is described to investigate achlorhydria. The efficacy of this test in the diagnostic investigation of pernicious anaemia was compared with that of serum pepsinogen I. Twenty one patients with pernicious anaemia--that is, patients with achlorhydria--and 22 with healed duodenal ulcer and normal chlorhydria were studied. Magnesium hydrogen breath test, serum pepsinogen I, serum gastrin, and standard gastric acid secretory tests were performed in all subjects. The mean (SEM) hydrogen peak value was lower in patients with pernicious anaemia than in the duodenal ulcer group (21.7 (1.9) v 71.3 (5.2) ppm; p = 0.00005). The hydrogen peak value had a 95.2% sensitivity and a 100% specificity to detect pentagastrin resistant achlorhydria. Mean serum pepsinogen I concentrations were also significantly lower in patients with pernicious anaemia than in the duodenal ulcer group (10.7 (2.7) v 123.6 (11.8) micrograms/l p = 0.00005). Sensitivity and specificity to detect pernicious anaemia were both 100% for pepsinogen I. It is concluded that this modified magnesium hydrogen breath test is a simple, noninvasive, cost effective, and accurate method to assess achlorhydria and may be useful in the diagnostic investigation of patients with suspected pernicious anaemia.

La Obra de Cayetano Garviso: 1807- post. 1871: cirujano vasco-navarro liberal en América

L'autor d'aquest llibre dona a conèixer alguns aspectes de l'exercici de la medicina en la dècada de 1840 a la zona del Río de la Plata, a partir de la figura del metge basc-navarrés Cayetano Garviso, cirurgià que emigrà a Argentina durant la Primera Guerra Carlista. Ara bé, tot i que aquest personatge es va moure per bona part de Sudamèrica, el treball es centra en la part de la seva biografia i el seu exercici professional desenvolupada a Espanya, Montevideo i Buenos Aires.