Clarithromycin-resistant H. pylori primary strains and virulence genotypes in the Northeastern region of Brazil

ABSTRACT The increase of H. pylori resistance to clarithromycin is a concern. This study evaluated the prevalence of H. pylori's primary resistance to clarithromycin and its association with virulence factors in adult dyspeptic patients and asymptomatic children. The gastric mucosa from patients (153 gastritis, 24 gastric cancer, 21 peptic ulcer) and gastric juice obtained by string test from 24 H. pylori and 23S rRNA positive asymptomatic children were included. The clarithromycin resistance was assessed by TaqMan RT-PCR 23S rRNA point mutations, A2142G and/or A2143G, and H. pylori virulence markers by PCR. Overall, the clarithromycin resistance was 14.4% (32/222), 14.2% in adults, and 12% in children, whereas origin, gender, and disease were not distinctive factors. The most prevalent point mutation was A2143G (62.5%). The point mutation was significantly less frequent in cagA-positive (11.4%) than in cagA-negative (23.6%) strains (p=0.03 OR = 0.4 95%CI = 0.19 - 0.91) as well as in cagE-positive (10.2%), cagE-negative (21.2%) (p=0.03 OR: 0.4 I.C:0.20-0.91). No difference was found in iceA or vacA alleles genotypes. Primary resistance to clarithromycin was lower than that reported in Southeast Brazil. The cagA and cagE positive H. pylori samples have few point mutations suggesting that individuals infected with virulent strains may be more susceptible to anti-H. pylori treatment.

Avaliação da influência das condições meteorológicas na concentração de material particulado fino (MP2,5) em Belo Horizonte, MG / Evaluation of meteorological conditions influence on fine particulate matter (PM 2.5 ) concentration in Belo Horizonte, MG, Brazil

RESUMO O agravamento da poluição atmosférica nos centros urbanos devido ao crescimento das instalações industriais e da frota veicular é um problema que causa danos ambientais, afetando também a saúde humana, principalmente pela inalação de material particulado fino (MP2,5). O objetivo deste estudo foi avaliar a influência das condições meteorológicas na concentração de MP2,5 em Belo Horizonte, utilizando dados amostrados entre o inverno de 2007 e o outono de 2008. Além disso, foram avaliadas as diferenças dos dados meteorológicos e da concentração do MP2,5 entre as estações do ano nesse período. Para tanto, foram realizados testes estatísticos de correlação entre os dados meteorológicos e a concentração de MP2,5, além de análises de significância para avaliação das diferenças entre esses dois parâmetros nos períodos seco e chuvoso, característicos da área de estudo. Foi observada diferença significativa entre a concentração do MP2,5 nos períodos seco e chuvoso. Foram também observadas diferenças significativas entre os parâmetros meteorológicos (umidade relativa; temperatura mínima, média e máxima; e direção do vento) para esses períodos. Por meio da análise de correlação de Spearman, observou-se correlação significativa entre a concentração do MP2,5 e os parâmetros meteorológicos precipitação e umidade relativa do ar.

ABSTRACT The increase of air pollution in urban centres due to the growth of industrial facilities and vehicular fleet is a problem that causes environmental damage and affects human health, mainly due to the inhalation of fine particulate matter (PM2.5). For this reason, the aim of this study was to evaluate the influence of meteorological conditions on PM2.5 concentration in Belo Horizonte, using data sampled from the winter of 2007 to the autumn of 2008. In addition, the differences in meteorological data and PM2.5 concentration between the seasons of the year in this study's period were also assessed. For this, correlation statistical tests were performed for meteorological data and PM2.5 concentration, as well as significance analysis to evaluate the differences between these two parameters in the dry and wet periods, characteristic of the study area. It was observed a significant difference between PM2.5 concentration in dry and wet periods. Significant differences were also observed between meteorological parameters (relative humidity, minimum, mean and maximum temperature and wind direction) for these periods. Spearman's correlation analysis showed a significant correlation between PM2.5 concentration and the meteorological parameters precipitation and relative humidity.

Effect of propranolol on capsular reaction around silicone implants in guinea pigs

PURPOSE: To evaluate the effect of propranolol on capsular architecture around silicone implants by measuring the inflammation, capsular thickness, and collagen fiber density, using a guinea pig experimental model. METHODS: Thirty six adult male guinea pigs randomly divided into two groups (n=18) were used. Each one received a silicone implant with textured-surface. The capsular tissue around implants from untreated or treated animals with the beta-adrenoceptor antagonist propranolol (10 mg/kg, dissolved in daily water) were analyzed for inflammation by histological scoring, capsular thickness by computerized histometry, and collagen fibers type I and Type III density by picrosirius polarization at different time points (7, 14 or 21 days after silicone implantation). RESULTS: Propranolol treatment reduced inflammation and impaired capsular thickness and delayed collagen maturation around the textured implant. CONCLUSION: Propranolol reduces the risk of developing capsular contracture around silicone implants with textured surface. .

Testis tumor associated to microlithiasis / Tumor de testiculo asociado a la microlitiasis / Tumor de testiculo associado a microlitiase

OBJECTIVE: To discuss the relationship between testicular microlithiasis and testis tumors in children and to consider the chances of testis preserving surgery in specific cases. CASE DESCRIPTION: Pre-adolescent presenting testicular microlithiasis and a larger left testis, corresponding to a cystic testicular tumor. The tumor was excised, with ipsilateral testis preservation. Histology diagnosed a testis dermoid tumor. COMMENTS: The relationship between testis tumors and testicular microlithiasis is ill defined in children. Pediatric urologists need to develop specific follow-up protocols for pre-pubertal children. .

OBJETIVO: Discutir las implicaciones de la microlitíasis testicular en el niño con relación al riesgo oncológico implicado y la posibilidad de cirugía de preservación testicular en casos elegidos. DESCRIPCIÓN DEL CASO: Pre-adolescente presentando aumento microlitíasis testicular y aumento del testículo izquierdo, con lesión tumoral quística. La lesión fue resecada, con preservación del testículo y diagnóstico histológico de tumor dermatoide testicular. COMENTARIOS: La relación entre tumores de testículo y microlitíasis testicular es mal definida en niños y hay la necesidad de desarrollar protocolos de seguimiento específicos para esa franja de edad. .

OBJETIVO: Discutir as implicações da microlitíase testicular na criança com relação ao risco oncológico envolvido e a possibilidade de cirurgia de preservação testicular em casos escolhidos. DESCRIÇÃO DO CASO: Pré-adolescente apresentava microlitíase testicular e aumento do testículo esquerdo, correspondendo a tumor testicular cístico. Ressecou-se o tumor, com preservação do testículo. O diagnóstico histológico foi de tumor dermoide testicular. COMENTÁRIOS: A relação entre tumores de testículo e microlitíase testicular é mal definida em crianças e há a necessidade de desenvolver protocolos de seguimento específicos para essa faixa etária. .

Fusariose em paciente imunocomprometido: sucesso terapêutico com voriconazol / Fusariosis in an immunocompromised patient: therapeutic success with voriconazole

A infecção por Fusarium solani é afecção fúngica potencialmente grave em pacientes imunocomprometidos, sobretudo naqueles portadores de neoplasias hematológicas. A mortalidade é alta,sendo limitadas as opções terapêuticas devido às condições da imunidade do doente e à relativa resistência do fungo aos antifúngicos utilizados de rotina. O voriconazol tem-se mostrado boa alternativa terapêutica em pacientes neutropênicos que apresentam fusariose refratária ou pouco responsiva à anfotericina B. Neste artigo relata-se caso de fusariose em doente imunocomprometido tratado com sucesso com voriconazol.

Fusarium infection is known to be potentially severe in immunocompromised patients, especially those with hematologic malignancies. Mortality rates are high and there are few therapeutic options, due to the severe underlying condition of this group of patients and the relative resistance of Fusarium to conventional antifungal therapy. Voriconazole has been shown to be an effective antifungal agent for neutropenic patients with fusariosis that are refractory or unresponsive to amphotericin B. We report the successful treatment of disseminated Fusarium infection in an immunocompromised host.

Seminoma primário do mediastino / Primary mediastinal seminoma

O seminoma é um tumor maligno de células germinativas que possui como sitio primário preferencial os testículos, embora existam raros casos de localização extra-gonadal. Os autores relatam caso de seminoma primário de mediastino em paciente masculino, 26 anos de idade, que apresentava dispnéia progressiva, tosse seca, rouquidão, dor torácica eventual, obstrução óbvia da veia cava superior e massa volumosa e palpável no mediastino ântero-superior. O diagnóstico etiológico foi suspeitado pelos exames de imagem, anatomopatológico e marcadores séricos e firmado pelo estudo imuno-histoquimico. Não havia evidência de metástase à distância, mas o tumor estava localmente avançado. O tratamento proposto foi poliquimioterápico com esquema PEB (cispiatina, etoposide e bleomicina) e o paciente evoluiu sem maiores intercorrências.

The seminoma is a malignant germ cell tumor that is rarely placed in an extra-testicular position. A 26 years old male patient with primary mediastinal seminoma was studied. His symptoms were: progressive dyspnea, unproductive cough, hoarseness, occasional chest pain, obvious superior vena cava obstruction, and a huge and palpable mass located in the upper anterior mediastinum. Image exams, serum markers and histological study led to diagnosis, of seminoma which was confirmed by immunohistochemical study. There was no evidence of distant metastatic disease although it was locally advanced. After the beginning of the treatment with chemotherapy, the patient's symptoms were improved.