Antiulcerogenic and antioxidant activities of Plantago ovata ethanolic extract in rats

Abstract This study aimed to determine the antiulcerogenic and antioxidant activities of Psyllium (Plantago ovata Forssk) seed ethanolic extract in rats. We assessed the antioxidant potential using free radical scavenging on DPPH, -carotene bleaching activity, ferric reducing power, and hydroxyl radical scavenging activity. In the antiulcerogenic study, pre-treatment with Plantago ovata seeds ethanolic extract (POE) (400 mg/kg b.wt) significantly protected against ethanol-induced gastric ulcer in rats by decreasing the ulcer index value and preserving the integrity of the gastric mucosa. The oxidative stress status in the stomach tissues showed a significant increase in the antioxidant enzyme levels of superoxide dismutase, catalase, and glutathione peroxidase with a significant decrease in lipid peroxidation during pre-treatment with POE. In conclusion, the POE protects against gastric ulcer due to its antioxidant potential and presence of bioactive molecules.

Resumo O presente estudo teve como objetivo determinar as atividades antiulcerogênica e antioxidante das sementes de Psyllium (Plantago ovata Forssk) em ratos. O potencial antioxidante foi avaliado utilizando o método do sequestro do radical livre DPPH, autooxidação do -caroteno, poder redutor de ferro e atividade de sequestro do radical hidroxila. No estudo antiulcerogênico, o pré-tratamento com o extrato etanólico das sementes de Plantago ovata (POE) (400 mg/Kg b.wt) reduziu a úlcera gástrica induzida pelo etanol em ratos, diminuindo o valor do índice de úlcera e preservando a integridade da mucosa gástrica. O estudo do estresse oxidativo nos tecidos estomacais mostrou um aumento significativo dos níveis das enzimas antioxidantes superóxido dismutase, catalase e glutationa peroxidase, com uma diminuição significativa da peroxidação lipídica enquanto pré-tratamento com POE. Em conclusão, o POE protege contra úlcera gástrica devido aos seus potenciais antioxidantes e à presença de moléculas bioativas.

Antiulcerogenic and antioxidant activities of Plantago ovata ethanolic extract in rats / Atividade antiulcerogênica e antioxidante do extrato etanólico de Plantago ovata em ratos

This study aimed to determine the antiulcerogenic and antioxidant activities of Psyllium (Plantago ovata Forssk) seed ethanolic extract in rats. We assessed the antioxidant potential using free radical scavenging on DPPH, ß-carotene bleaching activity, ferric reducing power, and hydroxyl radical scavenging activity. In the antiulcerogenic study, pre-treatment with Plantago ovata seeds ethanolic extract (POE) (400 mg/kg b.wt) significantly protected against ethanol-induced gastric ulcer in rats by decreasing the ulcer index value and preserving the integrity of the gastric mucosa. The oxidative stress status in the stomach tissues showed a significant increase in the antioxidant enzyme levels of superoxide dismutase, catalase, and glutathione peroxidase with a significant decrease in lipid peroxidation during pre-treatment with POE. In conclusion, the POE protects against gastric ulcer due to its antioxidant potential and presence of bioactive molecules.

O presente estudo teve como objetivo determinar as atividades antiulcerogênica e antioxidante das sementes de Psyllium (Plantago ovata Forssk) em ratos. O potencial antioxidante foi avaliado utilizando o método do sequestro do radical livre DPPH, autooxidação do ß-caroteno, poder redutor de ferro e atividade de sequestro do radical hidroxila. No estudo antiulcerogênico, o pré-tratamento com o extrato etanólico das sementes de Plantago ovata (POE) (400 mg/Kg b.wt) reduziu a úlcera gástrica induzida pelo etanol em ratos, diminuindo o valor do índice de úlcera e preservando a integridade da mucosa gástrica. O estudo do estresse oxidativo nos tecidos estomacais mostrou um aumento significativo dos níveis das enzimas antioxidantes superóxido dismutase, catalase e glutationa peroxidase, com uma diminuição significativa da peroxidação lipídica enquanto pré-tratamento com POE. Em conclusão, o POE protege contra úlcera gástrica devido aos seus potenciais antioxidantes e à presença de moléculas bioativas.

Prevalencia de neoplasia en úlceras gástrica perforada en el Servicio de Cirugía General- Hospital Central IPS, 2015-2020 / Prevalence of neoplasm in perforated gastric ulcers in the General Surgery Department - IPS Central Hospital, 2015-2020

Introducción: La úlcera gástrica perforada es la complicación ulcerativa más frecuente después del sangrado y la más grave de todas. A medida que se desarrolla el proceso inflamatorio la lesión gástrica evoluciona pasando por los siguientes estadíos: gastritis superficial, gastritis atrófica crónica, metaplasia intestinal, displasia y finalmente cáncer. En este proceso de evolución natural de la enfermedad radica la importancia de realizar una biopsia durante el abordaje quirúrgico de la úlcera gástrica perforada. Objetivos: Determinar la prevalencia de neoplasia en úlceras gástrica perforada en el servicio de Cirugía General del Hospital Central del Instituto de Previsión Social en el periodo 2015-2020. Materiales y métodos: Se llevó a cabo un estudio observacional descriptivo de corte transversal con datos retrospectivos. Resultados: Se incluyeron 50 pacientes sometidos a cirugía por úlcera gástrica perforada. El promedio de edad fue 67,1 ±17,1 años, el 60% correspondían al sexo masculino; en el 94% se realizó reavivamiento de bordes y en el 6% antrectomía. Con respecto al diagnóstico anatomopatológico, en el 90% se confirmó proceso infamatorio, la prevalencia de neoplasia fue del 6% y en el total de los pacientes postoperados por úlcera gástrica perforada se constató un 46% de mortalidad. Conclusión: La prevalencia de neoplasia fue mínima en los pacientes sometidos a cirugía por úlcera gástrica perforada. Se identificó un alto porcentaje de mortalidad en los pacientes postoperados por úlcera gástrica perforada. El promedio de edad fue 67,1 años y predominó el sexo masculino. El procedimiento quirúrgico más frecuente fue el reavivamiento de bordes y el diagnóstico anatomopatológico más prevalente fue proceso inflamatorio.

Introduction: Perforated gastric ulcer is the most frequent ulcerative complication after bleeding and the most serious of all; as inflammation progresses, gastric lesion evolves, beginning with superficial gastritis, then chronic atrophic gastritis, intestinal metaplasia, dysplasia, and finally cancer; hence the importance of performing a biopsy in the surgical approach of perforated gastric ulcer. Objectives: To determine the prevalence of neoplasia in perforated gastric ulcers in the General Surgery service of the Hospital Central del Instituto de Previsión Social in the period 2015-2020. Materials and methods: An observational descriptive cross-sectional study with retrospective data was carried out. Results: 50 patients who underwent surgery for perforated gastric ulcer were included. The average age was 67.1 ± 17.1 years, 60% were male; 94% underwent edge revival and 6% antrectomy. Regarding the anatomopathological diagnosis, 90% confirmed the inflammatory process, the prevalence of neoplasia was 6%, and in the total number of postoperative patients for perforated gastric ulcer, 46% mortality was confirmed. Conclusion: The average age was 67.1 years and the male sex predominated. The most frequent surgical procedure was edge revival and the most prevalent pathological diagnosis was inflammatory process. The prevalence of neoplasia was minimal in patients undergoing surgery for perforated gastric ulcer. A high percentage of mortality was identified in postoperative patients for perforated gastric ulcer.

Actividad analgésica y gastroprotectora de extractos e infusión de Minthostachys Mollis y Plantago Major

La muña y el llantén son plantas de la región andina de Bolivia, tradicionalmente sus hojas son utilizadas en forma de infusión debido a sus propiedades analgésica y gastroprotectora. Objetivo: evaluar la actividad analgésica y gastroprotectora de extractos e infusión de hojas de muña (Minthostachys mollis) y llantén (Plantago major), mediante de pruebas biológicas en Rattus norvegicus. Métodos: estudio de tipo experimental, prospectivo, longitudinal, en el que se evaluó la actividad analgésica y gastroprotectora en 30 Rattus norvegicus divididos en seis lotes: control, patrón, problema I, II, III, IV, a los cuales se les indujo contorsiones abdominales con ácido acético glacial y ulceras gástricas con etanol absoluto. Resultados: la infusión de muña y llantén presento 81,4% de actividad analgésica y un porcentaje por encima del 100% de efectividad, 60% de actividad gastroprotectora y 100% de efectividad con relación al número de lesiones. Asimismo, 69,6% de actividad gastroprotectora y 95,9% de efectividad con respecto al grado de la lesión. Estos porcentajes descritos fueron superiores en comparación a los porcentajes del extracto de muña, llantén, extractos combinados. La prueba de ANOVA un factor de Kruskal-Wallis, revelo diferencia estadística significativa (p0,05 (p=0,167 número de lesiones y p=0,384 grado de lesión); IC 95%). Conclusiones: la infusión de muña y llantén tienen mejor actividad analgésica y gastroprotectora en comparación con los extractos.

Muña and llantén are plants from the Andean region of Bolivia, traditionally their leaves are used as an infusion due to their analgesic and gastroprotective properties. Objective: to evaluate the analgesic and gastroprotective activity of extracts and infusion of muña (Minthostachys mollis) and llantén (Plantago major) leaves, using biological tests in Rattus norvegicus. Methods: an experimental, prospective, longitudinal study was conducted in which the analgesic and gastroprotective activity was evaluated in 30 Rattus norvegicus divided into six lots: control, standard, problem I, II, III, IV, to which abdominal convulsions were induced with glacial acetic acid and gastric ulcers with absolute ethanol. Results: the infusion of muña and llantén presented 81.4% analgesic activity and an effectiveness percentage above 100%, 60% gastroprotective activity and 100% effectiveness in relation to the number of lesions. Similarly, 69.6% gastroprotective activity and 95.9% effectiveness with respect to the degree of injury. These percentages described were higher in comparison to the percentages of muña extract, llantén extract, combined extracts. The ANOVA one-factor Kruskal-Wallis test revealed a statistically significant difference (p0.05 (p=0.167 number of lesions and p=0.384 degree of injury); 95% CI). Conclusions: the infusion of muña and llantén has better analgesic and gastroprotective activity compared to the extracts.

Causes of death of sows in three Brazilian pig farms / Causas de morte de matrizes suínas em três granjas brasileiras

Sow mortality is directly related to financial losses and productive efficiency in pig farms. Despite this, diseases associated with the death of sows are poorly understood. This study aimed to determine the main causes of death of sows in Brazilian pig farms. To perform this research, three Brazilian pig farms were visited, and necropsies were performed on all sows that had died spontaneously or were subjected to euthanasia. Tissue fragments were collected for histopathological and bacteriological examination. In addition, the clinical signs, productive stage, parity, and type of death (spontaneous or euthanasia) were recorded. A total of 138 necropsies were performed, and 132 had a conclusive diagnosis. The most frequent productive stages were gestation and lactation (33.3 and 31.9%, respectively), followed by parturient sows (17.4%), cull sows (9.4%), weaning-to-estrus interval (WEI) (4.3%), and unmated gilts (3.6%). The most affected organ systems were reproductive (28%), digestive (25%), locomotor (22%), cardiovascular (9.1%), and hematopoietic (6.1%). The most frequently diagnosed conditions were uterine prolapse (16/132; 12.1%), gastric ulcer (13/132; 9.8%), suppurative arthritis (11/132; 8.3%), liver lobe torsion (11/132; 8.3%), heart failure (9/132; 6.8%), vaginal or vaginal and rectal prolapse (9/132; 6.8%), and pododermatitis (8/132; 6.1%). Although 58.2% of the deaths were due to one of these seven diseases, there was a great variability in diagnoses.(AU)

A mortalidade de porcas está diretamente relacionada a perdas financeiras e à eficiência produtiva das granjas. Apesar disso, as doenças associadas à morte de porcas são pouco conhecidas. Este estudo teve como objetivo determinar as principais causas de morte de porcas em granjas suinícolas brasileiras. Para a realização desta pesquisa, três granjas brasileiras foram visitadas e necropsias foram realizadas em todas as porcas que morreram espontaneamente ou foram submetidas à eutanásia. Fragmentos de tecidos foram coletados para exame histopatológico e bacteriológico. Além disso, foram registrados os sinais clínicos, estágio reprodutivo, ordem de parto e tipo de morte (espontânea ou eutanásia). Um total de 138 necropsias foram realizadas e 132 tiveram um diagnóstico conclusivo. Os estágios produtivos mais frequentes foram gestação e lactação (33,3 e 31,9%, respectivamente), seguidos por porcas parturientes (17,4%), porcas de descarte (9,4%), intervalo desmame-estro (IDE) (4,3%) e leitoas vazias (3,6%). Os sistemas orgânicos mais afetados foram reprodutor (28%), digestivo (25%), locomotor (22%), cardiovascular (9,1%) e hematopoiético (6,1%). As condições mais frequentemente diagnosticadas foram prolapso uterino (16/132; 12,1%), úlcera gástrica (13/132; 9,8%), artrite supurativa (11/132; 8,3%), torção do lobo hepático (11/132; 8,3%), insuficiência cardíaca (9/132; 6,8%), prolapso vaginal ou prolapso vaginal e retal (9/132; 6,8%) e pododermatite (8/132; 6,1%). Embora 58,2% dos óbitos tenham ocorrido por uma dessas sete doenças, houve grande variabilidade de diagnósticos.(AU)

Helicobacter spp. and gastric lesions association in minipigs / Associação entre Helicobacter spp. e lesões gástricas em minipigs

ABSTRACT: Due to their similarity to humans, studies regarding gastric ulcers in pigs have become of great interest. It is known that Helicobacter spp. is related to the occurrence of these ulcers, as they possess a high prevalence in pigs. This study aimed to associate gastric lesions findings naturally occurring in minipigs related to or not related to the presence of Helicobacter spp., through the ultra-rapid urease test and immunohistochemical analysis, reaffirming the disease in swine as a natural biomedical model for human cases. For this, samples of formalin-fixed paraffin-embedded gastric tissues from 40 minipigs were obtained at the Laboratório de Morfologia e Patologia Animal (LMPA) in the Universidade Estadual do Norte Fluminense (UENF). Regarding the ultra-rapid urease test, no animal was positive in all regions. However, 18 were positive in at least one: six (15%) were positive in the aglandular region, eight (20%) in the antrum region, 13 (32.5%) in the region of the cardiac gland, and one (2.5%) in the region of the fundic gland. Regarding immunohistochemical analysis, only one animal was positive in all regions, and 32 animals were positive in at least one: four (10%) were positive in the aglandular region, 10 (25%) in the antrum region, 23 (57.5%) in the region of the cardiac gland, and three (7.5%) in the region of the fundic gland. The gastric lesion findings showed a close relationship with Helicobacter spp., enriching the laboratory animal pathologies list. The immunostaining of the bacteria not associated with gastric lesions in certain regions demonstrated the saprophytic and opportunisitic nature of Helicobacter.

RESUMO: Por sua semelhança com a da espécie humana, a úlcera gástrica nos suínos tem despertado muito interesse. Sabe-se que o Helicobacter spp. está relacionado à ocorrência dessas úlceras, apresentando alta prevalência. Este estudo teve como objetivo associar as lesões gástricas, de ocorrência natural em miniporcos, à presença, ou não, de Helicobacter spp., por meio do teste ultra-rápido da urease e da análise imunohistoquímica, reafirmando a enfermidade em suínos como modelo biomédico natural para os casos em humanos. Para este fim, foram utilizados histossetes de tecido gástrico de 40 minipigs obtidos no Laboratório de Morfologia e Patologia Animal (LMPA) da Universidade Estadual do Norte Fluminense (UENF). Em relação ao teste ultra-rápido da urease, nenhum animal foi positivo em todas as regiões, entretanto, 18 foram positivos em pelo menos uma: seis foram positivos na região aglandular, oito na região do antro, 13 na região das glândulas cárdicas e um na região das glândulas fúndicas. Em relação à análise imuno-histoquímica, somente um animal foi positivo em todas as regiões e 32 animais foram positivos em pelo menos uma: quatro foram positivos na região aglandular, 10 na região do antro, 23 na região das glândulas cárdicas e três na região das glândulas fúndicas. As lesões gástricas demonstraram estreita relação com o Helicobacter spp. em miniporcos, enriquecendo a lista de patologias de animais de laboratório. A imunomarcação da bactéria não associada à lesão, em certas regiões gástricas, demonstra seu caráter saprofítico e oportunista.

Causes of death in growing-finishing pigs in two technified farms in southern Brazil / Causas de morte em suínos de crescimento e terminação em duas granjas tecnificadas no Sul do Brasil

The aim of this study was to investigate the main causes of death in growing-finishing pigs in southern Brazil. During a one-year period (from 2018 to 2019), two industrial pig herds (18 and 20 thousand pigs each farm) in southern Brazil were monitored along the four seasons of the year (12 days per season on each farm), in order to perform necropsies of all pigs that died in that period. The two farms had an average monthly mortality rate ranging from 0.94 to 3.93% in the evaluated months. At necropsy, tissues were collected, fixed in 10% formalin solution and processed routinely for histopathological examination. When necessary, samples were sent for bacterial culture and PCR to identify etiologic agents. A total of 601 necropsies were performed, with 94.9% of conclusive diagnoses. Infectious diseases corresponded to 64.4% of conclusive diagnosis and non-infectious diseases to 35.6%. The most prevalent causes of death were: pneumonia (33%), gastric ulcers (15.4%), circovirosis (9.9%), systemic bacterial embolism (5.4%), polyserositis (4.4%), dilated cardiomyopathy and torsion of abdominal organs (4.3% each), and bacterial pericarditis (3.4%). Regarding pneumonias (199/601), the main agents identified in these cases were Pasteurella multocida, Influenza A virus and Mycoplasma hyopneumoniae, mainly in associations.(AU)

O objetivo do presente trabalho foi investigar as principais causas de morte de suínos em fase de crescimento e terminação no Sul do Brasil. Durante o período de um ano (entre 2018 e 2019), duas granjas tecnificadas de suínos no Sul do Brasil foram acompanhadas nas quatro estações (12 dias por estação em cada granja), para realização de necropsias dos suínos que morreram nesse período. As duas propriedades apresentavam mortalidade mensal média entre 0,94 e 3,93% nos meses avaliados. Na necropsia, amostras de órgãos foram colhidas, fixadas em formol 10% e processadas rotineiramente para o exame histopatológico. Quando necessário, amostras foram enviadas para o cultivo bacteriano e PCR para identificação de agentes etiológicos. Foram realizadas um total de 601 necropsias, com 94,9% de diagnósticos conclusivos. As doenças infecciosas corresponderam a 64,4% dos diagnósticos conclusivos e as não infecciosas a 35,6%. As principais causas de morte foram: pneumonias (33%), úlcera gástrica (15,4%), circovirose (9,9%), embolia bacteriana sistêmica (5,4%), polisserosite (4,4%), cardiomiopatia dilatada e torção de órgãos abdominais (4,3% cada) e pericardite bacteriana (3,4%). Com relação às pneumonias (199/601), os principais agentes associadas as lesões foram Pasteurella multocida, vírus da Influenza A e Mycoplasma hyopneumoniae, principalmente associados entre si.(AU)

Antiulcerogenic effects of selected African nightshades (Solanum nigrum Linn. ) genotypes on the rat stomach: a morphologic and morphometric study / Efectos antiulcerogénicos de genotipos seleccionados de solanáceas Africanas (Solanum nigrum Linn. m) en el estómago de ratas: un estudio morfológico y morfométrico

Solanum nigrum (SLN), commonly known as African nightshade, is used as a vegetable as well as in the management and treatment of various ailments including gastric ulcers. We analyzed, both grossly and microscopically using H&E, Masson's trichrome and PSA staining methods, the protective effects of aqueous leaf extracts of three Kenyan SLN genotypes namely S. scabrum (SSB), S. sarrachoides (SSR) and S. villosum (SVL) on ethanol-induced gastric lesions in rats. There was evidence of gastro-protection by all the three genotypes with the SSB showing the highest ulcer inhibition score (76.37 %) followed by SSR (72.51 %) and SVL (63.30 %). SLN-pretreated rats showed less areas of gastric mucosal surface erosion. Additionally in the pretreated animals, the depth of the ulcers were markedly reduced, reaching only the gastric pit region except in those treated with SVL where the ulcers penetrated slightly more deeply to affect the gastric glands. Compared with controls, the mean microscopic ulcer index decreased 5.07, 3.55 and 2.37-fold in rats pretreated with SSB, SSR and SVL extracts respectively. Results of this work show extracts of the three SLN genotypes to have antiulcerogenic potential but at varied strengths, thus confirming earlier reports that phytoconstituents and hence the efficacy of a medicinal plant may be influenced by genetic factors.

Solanum nigrum (SLN), comúnmente conocida como la solanácea africana, se usa como vegetal, para el tratamiento de diversas dolencias incluyendo las úlceras gástricas. Analizamos de forma macro y microscópica, de forma macroscópica y microscópica, utilizando para ello tinciones de H&E, tricrómico de Masson y PSA los efectos protectores de extractos acuosos de hojas de tres genotipos SLN de Kenia: S. scabrum (SSB), S. sarrachoides (SSR) and S. villosum (SVL) en lesiones gástricas inducidas por etanol en ratas. Hubo evidencia de gastroprotección por parte de los tres genotipos con el SSB mostrando el puntaje más alto de inhibición de la úlcera (76,37 %) seguido de SSR (72,51 %) y SVL (63,30 %). Las ratas tratadas previamente con SLN mostraron menos áreas de erosión de la superficie de la mucosa gástrica. Además, en los animales pretratados, la profundidad de las úlceras se redujo notablemente, llegando solo a la región del fondo gástrico, excepto en aquellos tratados con SVL donde las úlceras penetraron un poco más profundamente para afectar las glándulas gástricas. En comparación con los controles, el índice medio de úlcera microscópica disminuyó 5,07, 3,55 y 2,37 veces en ratas pretratadas con extractos de SSB, SSR y SVL, respectivamente. Los resultados de este trabajo muestran que los extractos de los tres genotipos de SLN tienen potencial antiulcerogénico en diferentes concentraciones, lo que confirma informes anteriores que los fitoconstituyentes y la eficacia de una planta medicinal pueden estar influenciados por factores genéticos.

Evaluación de algunos factores de riesgo para la presentación de síndrome de úlcera gástrica (SUGE) en el caballo criollo colombiano en el Valle de Aburrá, Antioquia (Colombia) / Evaluation of some risk factors for the presentation of equine gastric ulcer syndrome (EGUS) in colombian creole horse in Valle de Aburrá, Antioquia (Colombia)

RESUMEN Las úlceras gástricas se definen como la pérdida de continuidad de la mucosa gástrica. Se originan principalmente por desequilibrio entre factores injuriantes y de protección del estómago. Generalmente se manifiestan con signos como pérdida de peso, cólico, bruxismo e inapetencia, conllevando al bajo rendimiento del animal y pérdidas económicas. El objetivo del presente estudio fue determinar la prevalencia y factores de riesgo para la presentación de SUGE en CCC del Valle de Aburra. Se realizó gastroscopia a 100 animales de diferentes pesebreras, entre dos y 25 años de edad; cada estómago se caracterizó macro y microscópicamente. Las lesiones macroscópicas se valoraron de acuerdo con el grado de lesión según el Equine Gastric Ulcer Council, y la clasificación microscopica se basó en una adaptación hecha por patrones de descripción de lesiones más utilizados como: The sidney system y Equine gastritis grading system (EGGS). Para el análisis de los resultados, se tuvieron en cuenta variables como la intensidad del ejercicio, alojamiento, tipo y frecuencia de alimentación, transporte y frecuencia del mismo. El 65% de los equinos evaluados presentaron lesiones compatibles con SUGE. Macroscópicamente el grado 2 de severidad fue el más común (38%), con mayor presentación en la región aglandular. Microscópicamente el edema en la región fundica y pilórica fue la lesión más frecuente (35,2% y 30,7%, respectivamente). Los principales factores de riesgo asociados a la presentación de las lesiones fueron el transporte de los animales y la intensidad del ejercicio.

ABSTRACT Gastric ulcers are defined as the loss of continuity of the gastric mucosal. They are mainly caused by an imbalance between harmful and protective factors of the stomach. It generally manifests itself with signs such as weight loss, colic, bruxism and inappetence, which can lead to low performance and economic losses. The objective of the present study was to determine the prevalence and risk factors for the presentation of SUGE in CCC of the Valle del Aburra. Gastroscopy was made to 100 animals from different stables, between two and 25 years of age; each stomach characterized, macro and microscopically. Lesions are evaluate depending on the degree of injury to the "Equine Gastric Ulcer Council". Microscopic lesions classification was based on an adaptation by patterns most commonly used description of injuries such as: the Sidney System and the equine gastritis grading system (EGGS). For the analysis of the results, variables such as exercise intensity, accommodation, type and frequency of feeding, transportation and its frequency were taken into account. 65% of the equines evaluated presented SUGE-compatible lesions, of which the most common degree of severity macroscopically was grade 2 (38%), with grater presentation in the non-glandular region. Microscopically, edema in the fundic and pyloric region was the most frequent (35.2% and 30.7%, respectively). The main risk factors associated with the presentation of the lesions were the transport of the animals and the intensity of the exercise.

Actividad gastroprotectora, tamizaje fitoquímico y actividad atrapadora de radicales libres de Aloysia Gratissima (Verbenaceae) / Phytochemical screning, gastroprotective activity and free radical scavenging activity of Aloysia gratissima (Verbenaceae)

Se evaluó la actividad gastroprotectora de la infusión proveniente de las hojas de Aloysia gratissima (Verbenaceae), especie nativa de interés medicinal que se desarrolla en el sudoeste bonaerense, utilizando un modelo de inducción de úlceras gástricas con etanol en ratones. Se realizó un tamizaje fitoquímico para detectar la presencia de compuestos que podrían ser responsables de la actividad gastroprotectora de la planta. Se determinó el contenido de fenoles totales y la capacidad atrapadora de radicales libres mediante el método del Folin-Ciocalteu y del 2,2'-difenil-1-picrilhidrazilo (DPPH), respectivamente. Los ensayos demostraron que la infusión de la planta, administrada por vía oral en dosis de 100, 500 y 1000 mg/kg, ejerció una gastroprotección significativa frente a la inducción de úlceras. Se detectó una actividad atrapadora de radicales libres de 47,5%, similar a la sustancia de referencia (BHT). El estudio fitoquímico detectó la presencia de flavonoides y otros polifenoles, sustancias con reconocida capacidad antioxidante. Estos metabolitos ejercen efectos protectores en diferentes modelos experimentales de inducción de úlceras mediante mecanismos que pueden involucrar la neutralización de radicales libres, lo que podría explicar la actividad gastroprotectora de la planta. Estos hallazgos requieren estudios adicionales de A. gratissima como una posible terapia frente a la úlcera gástrica. (AU)

The gastroprotective activity of the infusion from the leaves of Aloysia gratissima (Verbenaceae), a native species of medicinal interest growing in South West Buenos Aires, was evaluated in an ethanol-induced gastric ulcer model in mice. Phytochemical screening was carried out in order to determine the presence of compounds that could be responsible for the pharmacological effects of the plant. Total phenolic content and the free radical scavenging activity of the plant were determined using the Folin-Ciocalteu and the 2,2'-diphenyl1-picrylhydrazyl (DPPH) method, respectively. Assays demonstrated that the infusion, orally administered at 100, 500, and 1000 mg/kg doses, exerted a significant gastroprotection effect against ulcer induction (P<0,05). A free radical scavenging activity of 47.5% -similar to the reference substance (BHT)- was detected. Phytochemical screening revealed the presence of antioxidant compounds such as flavonoids and other phenolic compounds. These compounds exert protective effects in different experimental models of ulcer induction that could involve free radical neutralization, which could explain the gastroprotective activity of the plant. These promising results support additional studies of A. gratissima as a potential therapy against gastric ulcer. (AU)

Associação de alterações anatomopatológicas com o Helicobacter spp. por meio de análise imuno-histoquímica em estômagos de leitões

O objetivo deste trabalho foi relacionar os achados anatomopatológicos das lesões gástricas subclínicas de ocorrência natural em leitões com a presença, ou não, de Helicobacter spp. por meio da imuno-histoquímica. Foram utilizados 48 leitões de linhagem genética comercial. Os animais foram adquiridos em uma granja comercial, com peso médio de 34 Kg e idade média de 79 dias; após o abate, seus estômagos foram coletados e avaliados. Avaliações histopatológicas e imuno-histoquímicas foram realizadas em amostras das regiões anatômicas aglandular e glandular. Macroscopicamente, 34 (70,83%) leitões apresentaram lesões na região aglandular, enquanto que em 14 animais (29,17%) não foram encontradas alterações nesta região. Dos estômagos com lesão, 14 foram classificados como grau 1, seis como grau 2 e 14 como grau 3. Microscopicamente, 44 amostras (91,66%) apresentaram paraqueratose. Deste total, 22 apresentaram a forma discreta, 20 a moderada e dois a acentuada. Na avaliação macroscópica da porção glandular, 41 (85,4%) animais apresentaram alteração em pelo menos uma das três regiões, e em somente sete (14,6%) não foram encontradas lesões em nenhuma delas. Em 14 deles, houve aumento da atividade mucípara, em dois, houve erosão e, em cinco, hiperemia.  As lesões na região glandular do estômago foram mais extensas no antro e no cárdia, seguidas do fundo. Em relação à análise imuno

The aim of this study was to relate the anatomopathological findings of naturally occurring subclinical gastric lesions in piglets, with or without Helicobacter spp. through immunohistochemistry. Forty-eight piglets of commercial genetic lineage were used. The animals were acquired in a commercial farm, with an average weight of 34 kg and an average age of 79 days, and after slaughter, their stomachs were collected and evaluated. Samples from the glandular and aglandular anatomical regions were evaluated. Macroscopically, 34 (70.83%) samples had lesions on aglandular region, while 14 (29.17%) nothing had. Of the injured stomachs, 14 were classified as grade 1, six as grade 2 and 14 as grade 3. Microscopically, 44 samples (91.66%) showed parakeratosis. Of these, 22 showed a discreet manner, 20 moderate and two severe. In the glandular region, in 41 (85.4%) samples there was a change in at least one of the three regions, and only seven animals (14.6%) showed no change in any of the three. Fourteen samples showed increased muciparous activity, two showed erosion and five hyperemia. The lesions were higher in antral regions and cardic, followed the fundus. In relation to immunohistochemistry, 21(43.8%) samples were negative in all areas, 24 (50%) were positive in at least one, and none were positive in all. The anatomopathological findings showed a statistical relationship with the bacteria, and its immunostaining, not associated with gastric lesions in certain regions, demonstrates its saprophytic and opportunistic character.

Associação de alterações anatomopatológicas com o Helicobacter spp. por meio de análise imuno-histoquímica em estômagos de leitões / Association of anatomopathological changes with the Helicobacter spp. through immunohistochemical analysis in piglets stomachs

O objetivo deste trabalho foi relacionar os achados anatomopatológicos das lesões gástricas subclínicas de ocorrência natural em leitões com a presença, ou não, de Helicobacter spp. por meio da imuno-histoquímica. Foram utilizados 48 leitões de linhagem genética comercial. Os animais foram adquiridos em uma granja comercial, com peso médio de 34 Kg e idade média de 79 dias; após o abate, seus estômagos foram coletados e avaliados. Avaliações histopatológicas e imuno-histoquímicas foram realizadas em amostras das regiões anatômicas aglandular e glandular. Macroscopicamente, 34 (70,83%) leitões apresentaram lesões na região aglandular, enquanto que em 14 animais (29,17%) não foram encontradas alterações nesta região. Dos estômagos com lesão, 14 foram classificados como grau 1, seis como grau 2 e 14 como grau 3. Microscopicamente, 44 amostras (91,66%) apresentaram paraqueratose. Deste total, 22 apresentaram a forma discreta, 20 a moderada e dois a acentuada. Na avaliação macroscópica da porção glandular, 41 (85,4%) animais apresentaram alteração em pelo menos uma das três regiões, e em somente sete (14,6%) não foram encontradas lesões em nenhuma delas. Em 14 deles, houve aumento da atividade mucípara, em dois, houve erosão e, em cinco, hiperemia. As lesões na região glandular do estômago foram mais extensas no antro e no cárdia, seguidas do fundo. Em relação à análise imuno-histoquímica, 21 (43,8%) amostras tiveram resultados negativos em todas as regiões, e 24 (50%) foram positivas em pelo menos uma delas, sendo que nenhuma foi positiva em todas. Os achados anatomopatológicos demonstraram relação estatística com a bactéria e, sua imunomarcação não associada à lesão em certas regiões gástricas, demonstra seu caráter saprofítico e oportunista.

The aim of this study was to relate the anatomopathological findings of naturally occurring subclinical gastric lesions in piglets, with or without Helicobacter spp. through immunohistochemistry. Forty-eight piglets of commercial genetic lineage were used. The animals were acquired in a commercial farm, with an average weight of 34 kg and an average age of 79 days, and after slaughter, their stomachs were collected and evaluated. Samples from the glandular and aglandular anatomical regions were evaluated. Macroscopically, 34 (70.83%) samples had lesions on aglandular region, while 14 (29.17%) nothing had. Of the injured stomachs, 14 were classified as grade 1, six as grade 2 and 14 as grade 3. Microscopically, 44 samples (91.66%) showed parakeratosis. Of these, 22 showed a discreet manner, 20 moderate and two severe. In the glandular region, in 41 (85.4%) samples there was a change in at least one of the three regions, and only seven animals (14.6%) showed no change in any of the three. Fourteen samples showed increased muciparous activity, two showed erosion and five hyperemia. The lesions were higher in antral regions and cardic, followed the fundus. In relation to immunohistochemistry, 21(43.8%) samples were negative in all areas, 24 (50%) were positive in at least one, and none were positive in all. The anatomopathological findings showed a statistical relationship with the bacteria, and its immunostaining, not associated with gastric lesions in certain regions, demonstrates its saprophytic and opportunistic character.

Controversias en cirugía: Erradicación del Helicobacter pylori ¿Terapia a todos o según indicaciones usuales? / Controversies in surgery: Eradication of Helicobacter pylori. Therapy for all or according to usual indications?

La infección por Helicobacter pylori (H. pylori), es la infección bacteriana crónica más frecuente de la raza humana, afecta al 50 % de la población mundial y, por lo menos, al 80 % de la población colombiana. Esta bacteria es re-conocida desde hace más de 15 años como un carcinógeno tipo I. De acuerdo con las indicaciones del Consenso de "Maastricht V" esta infección debe ser buscada y tratada en los pacientes con úlcera péptica activa, linfoma MALT (por sus siglas en inglés, mucosa associated lymphoid tissue), cáncer gástrico temprano, púrpura que presenten síntomas dispépticos crónicos y usuarios crónicos de AINES. Debido al papel que tiene en la fisiopatología del cáncer gástrico, nace la iniciativa de realizar una búsqueda activa del H. pylori y erradicarlo en todas las personas, incluyendo aquellas asintomáticas en países con alta incidencia de esta neoplasia. Existen diversas publicaciones alrededor del mundo que así lo sugieren, mostrando resultados con impacto positivo en el curso y progresión de la enfermedad, sobre todo en las etapas más tempranas de la infección. Sin embargo, otros autores resaltan la creciente problemática de la resistencia bacteriana, y demuestran que el peso estadístico y los diferentes análisis de los estudios disponibles en la actualidad tienen poca validez para dar una recomendación extendida al paciente asintomático. Se cuestiona que tal vez, estamos utilizando las estrategias inadecuadas para manejar una situación de salud pública, ya que estamos enfocados en impactar a cada individuo con terapias antibióticas complejas, en vez de a la población en general con políticas de salud pública

Helicobacter pylori (H. pylori) infection is the most frequent chronic bacterial infection in humans, affecting 50% of the world population, and at least 80% of the Colombian population. This bacteria has been recognized for more than 15 years as a type I carcinogen. According to the indications of the "Maastricht V" consensus, this infection should be sought and treated in patients with: active peptic ulcer, MALT lymphoma (for its acronym Mucosa associated lymphoid tissue), early gastric cancer, purpura who present with chronic dyspeptic symptoms and chronic users of NSAIDs. Due to the role it plays in the pathophysiology of gastric cancer, the initiative was born to carry out an active search for H. pylori and eradicate it in all people, including those asymptomatic in countries with a high incidence of this neoplasia.There are various publications around the world that suggest the effectiveness of this treatment and the positive impact on the course and progression of the disease, especially in the earliest stages of the infection, since the more advanced stages have less encouraging results regarding progression to malignancy. However, other authors highlight the growing problem of bacterial resistance that we are currently facing and demonstrate that the sta-tistical weight and the different analyzes of the currently available studies have little validity to give an extended recommendation to the asymptomatic patient. It is suggested that perhaps inappropriate strategies to manage this public health situation are being used, since we are focused on impacting each individual with complex antibiotic therapies, instead of the general population with public health policies

Tratamiento del sangrado digestivo alto / Upper digestive tract bleeding treatment

El sangrado digestivo alto (SDA) se define como la presencia de sangre en el tracto digestivo alto, proveniente de la mucosa o vasos sanguíneos que se localizan entre el esófago y el ángulo de Treitz. Las principales manifestaciones clínicas asociadas al SDA están dadas por la presencia de hematemesis, melena y en algunos casos hematoquezia, esta última relacionada con sangrados que cursan con aceleración del tránsito intestinal. En el Hospital de Especialidades Carlos Andrade Marín el SDA es un motivo frecuente de consulta en urgencias, que implica además un importante número de ingresos tanto al área crítica de Urgencias, Unidad de Cuidados Intensivos y hospitalización. La mortalidad por esta causa es variable, se estima en 3,5% al 10,0% y esta depende sobre todo de la edad del paciente y sus posibles enfermedades asociadas, la cuantía del sangrado y los hallazgos que se encuentren durante la realización del procedimiento endoscópico. El sangrado digestivo alto es autolimitado o cesa espontáneamente en el 80,0% de los casos. La causa más frecuente es la hemorragia por úlcera péptica (25,0% ulcera duodenal­23,0% ulcera gástrica). Con este protocolo clínico buscamos normar el manejo hospitalario de los pacientes que ingresan al área de Urgencias con el fin de unificar criterios que conlleven al manejo adecuado de los pacientes con sangrado digestivo alto.

Upper digestive tract bleeding (SDA) is defined as the presence of blood in the upper digestive tract, coming from the mucosa or blood vessels that are located between the esophagus and the Treitz angle. The main clinical manifestations associated with SDA are given by the presence of hematemesis, melena and in some cases hematochezia, the latter related to bleeding that occurs with the acceleration of intestinal transit. In the Hospital of Specialties Carlos Andrade Marín, the SDA is a frequent reason for consultation in the emergency room, which also implies an important number of admissions to the critical area of Emergency, Intensive Care Unit and hospitalization. Mortality from this cause is variable, it is estimated at 3,5% to 10,0% and this depends above all on the age of the patient and their possible associated diseases, the amount of bleeding and the findings that are found during the performance of the endoscopic procedure. High digestive bleeding is self-limiting or ceases spontaneously in 80,0% of cases. The most frequent cause is peptic ulcer hemorrhage (25,0% duodenal ulcer -23,0% gastric ulcer). With this clinical protocol, we seek to regulate the hospital management of patients who enter the Emergency Department to unify criteria that lead to the proper management of patients with high digestive bleeding.

O mel-derivado de Lactobacillus rhamnosus alivia a infecção gastro-intestinal induzida pelo Helicobacter pylori-e inflamação gástrica em C57Bl/6 ratos: um estudo imuno-histológico / Honey-derived lactobacillus rhamnosus alleviates helicobacter pylori-induced gastro-intestinal infection and gastric inflammation in c57bl/6 mice: an immuno-histologic study

ABSTRACT BACKGROUND: Helicobacter pylori (H. pylori) has been introduced by since 1983 by Marshal and Warren to play the main role in the pathophysiology of gastritis and gastric ulcers. Almost half of the world population1 is infected by H. pylori. Current therapeutic regimen against H. pylori includes the use of a proton pump inhibitor plus two or more antibiotics. However, the efficacy of this regimen is decreasing mainly due to antibiotic resistance and side effects of medications. This fact has resulted in public interest in other therapeutic options and the role of probiotics merits special attention in this regard. OBJECTIVE: This study aims to evaluate the efficacy of honey-derived Lactobacillus rhamnosus on H. pylori-induced gastric inflammation and gastro-intestinal infection in C57BL/6 Mice. METHODS: The 24 C57BL/6 Mice were randomly divided into three groups of eight mice each. All the mice were fed with 1cc suspension containing 5*1010 CFU/ mL of ATCC43504 strains of H. pylori for 3 consecutive days, twice daily via polyethylene gavage tubes. At the end of 4th week, infection with H. pylori was confirmed with stool Ag (ELISA) and following sacrifice of one mouse from each group, histopathologic study confirmed gastritis. The groups were subjected to different therapies as stated, 1: without Bismuth (Bi), Omeprazole (Om) and L. rhamnosus prescription, 2: Bi, Om and Clarithromycin (Cl) and 3: Bi, Om plus 1cc of suspension of 109 CFU/mL of L. rhamnosus. After 2 weeks, the stool was analyzed for Ag and the mice were sacrificed for evaluation of histopathologic changes. RESULTS: Treatment with L. rhamnosus group provided Zero titer of stool Ag and was associated with improved gastric inflammation in all subjects, similar to the clarithromycin group. CONCLUSION: Honey-derived L. rhamnosus probiotics provides similar results as clarithromycin in terms of improvement of H. pylori infection and gastritis in C57BL/6 Mice model, without its cons of antibiotic resistance.

RESUMO CONTEXTO: O Helicobacter pylori (H. pylori) foi reconhecido em 1983 por Marechal e Warren como protagonista principal na fisiopatologia de gastrite e úlceras gástricas. Quase metade da população mundial está infectada por H. pylori. O regime terapêutico atual contra H. pylori inclui o uso de um inibidor da bomba de prótons associada a dois ou mais antibióticos. No entanto, a eficácia deste regime está diminuindo principalmente devido à resistência aos antibióticos e efeitos colaterais de medicamentos. Este fato resultou no interesse público em outras opções terapêuticas e o papel dos probióticos merece atenção especial a este respeito. OBJETIVO: Este estudo visa avaliar a eficácia do mel-derivado do Lactobacillus rhamnosus na inflamação gástrica e infecção gastrointestinal H. pylori-induzida em camundongos C57Bl/6. MÉTODOS: Vinte e quatro camundongos C57Bl/6 foram divididos aleatoriamente em três grupos de oito camundongos cada. Todos os ratos foram alimentados com suspensão de 1cc contendo 5*1010 UFC/mL de cepas ATCC43504 de H. pylori por 3 dias consecutivos, duas vezes por dia através de gavagem por tubos de polietileno. No final da 4ª semana, a infecção com H. pylori foi confirmada pelo antígeno fecal (ELISA) e após o sacrifício de um rato de cada grupo, o estudo histopatológico confirmou gastrite. Os grupos foram submetidos a diferentes terapias, como indicado, 1: sem prescrição de bismuto (BI), Omeprazol (Om) e L. rhamnosus, 2: Bi, Om e claritromicina (CL) e 3: Bi, Om mais 1cc de suspensão de 109 UFC/mL de L. rhamnosus. Após 2 semanas, as fezes foram analisadas para o antígeno e os ratos foram sacrificados para a avaliação das alterações histopatológicas. RESULTADOS: O tratamento com o grupo L. rhamnosus forneceu o título zero de antígeno e foi associado com a inflamação gástrica melhorada em todos os camundongos, similar ao grupo claritromicina. CONCLUSÃO: O probiótico mel-derivado L. rhamnosus fornece resultados semelhantes ao da claritromicina em termos de melhoria da infecção H. pylori e gastrite em C57Bl/6 camundongos modelos, sem os inconvenientes de resistência aos antibióticos.

Caso Clínico: Tumor Neuroendocrino Gástrico / Case Report: Gastric Carcinoid

INTRODUCCIÓN: Los tumores neuroendocrinos gástricos son tumores de muy baja prevalencia, constituyendo el aproximadamente 1.8 % de los tumores gástricos. Suelen ser solitarios, con un tamaño entre 4 y 8 cm, con más frecuencia en el sexo masculino con edad promedio de presentación entre 60 - 70 años. Su diagnóstico es cada vez mayor, gracias al uso generalizado de la endoscopia digestiva alta, siendo ésta la prueba de oro. En cuanto a su tratamiento, la resección quirúrgica de los tumores carcinoides gástricos es de elección cuando no se puede optar por resección endoscópica. CASO CLÍNICO: Paciente de 45 años con cuadro clínico de epigastralgia, náusea y diarrea, de dos meses de evolución. Se realiza endoscopía digestiva alta con reporte de úlcera de antro Forrest III. Biopsia: neruroendocrino grado II. Tomografia abdomen: sin datos de actividad en otro sitio fuera de estómago. EVOLUCIÓN: Se realizó gastrectomía subtotal, con reporte negativo en el estudio transoperatorio de líquido de lavado peritoneal. El reporte de patología confirmó el diagnóstico de tumor neuroendócrino GII 3.5 cm unifocal; en estadio III B según las guías clínicas, con vigilancia por un período de un año sin actividad tumoral. CONCLUSIÓN: Al ser el tumor neuroendocrino gástrico un tipo de cáncer poco frecuente, la endoscopía digestiva alta fue fundamental en el diagnóstico de este caso que le llevó al paciente a buscar evaluación médica. Sin embargo, para disminuir el riesgo de su incidencia se recomienda una alimentación rica en frutas, y verduras frescas acompañado de una actividad física adecuada.

BACKGROUND: Gastric neuroendocrine are very low tumors prevalence, constituting approximately 1.8 % of gastric tumors. They are usually solitary, with a size between 4 and 8 cm, most often in the male with average age of presentation between 60 - 70 years. It is diagnosis is increasing, thanks to the widespread use of upper digestive endoscopy, this being the gold standar. Regarding it is treatment; surgical resection of gastric neruroendocrine tumors is one of the choices when endoscopic resection is not possible. CASE REPORT: 45-year-old patient refers epigastralgia, nauseas and diarrhea, since two months ago. Upper digestive endoscopy is performed with report of Forrest III antrum ulcer. Biopsy: grade II neuroendocrine tumor. Abdominal tomography: no activity data in another place outside the stomach. EVOLUTION: Subtotal gastrectomy was performed, with a negative report in the transoperative study of peritoneal lavage fluid. The pathology report confirmed the diagnosis of unifocal neuroendocrine GII 3.5 cm tumor; in stage III B according to clinical guidelines, with surveillance for a period of one year without tumor activity. CONCLUSION: The gastric neuroendocrine is a rare type of cancer; upper gastrointestinal endoscopy was a fundamental in the diagnosis of this case that led the patient to seek medical evaluation. However, to reduce it is incidence is recommended to eat a diet rich in fruits, and fresh vegetables accompanied by adequate physical activity.

Evolution of incidence, mortality and cost of nontraumatic abdominal emergencies treated in Brasil in a period of nine years

SUMMARY OBJECTIVE: To evaluate the incidence, mortality and cost of non-traumatic abdominal emergencies treated in Brazilian emergency departments. METHODS: This paper used DataSus information from 2008 to 2016 (http://www.tabnet.datasus.gov.br). The number of hospitalizations, costs - AIH length of stay and mortality rates were described in acute appendicitis, acute cholecystitis, acute pancreatitis, acute diverticulitis, gastric and duodenal ulcer, and inflammatory intestinal disease. RESULTS: The disease that had the highest growth in hospitalization was diverticular bowel disease with an increase of 68.2%. For the period of nine years, there were no significant changes in the average length of hospital stay, with the highest increase in gastric and duodenal ulcer with a growth of 15.9%. The mortality rate of gastric and duodenal ulcer disease increased by 95.63%, which is significantly high when compared to the other diseases. All had their costs increased but the one that proportionally had the highest increase in the last nine years was the duodenal and gastric ulcer, with an increase of 85.4%. CONCLUSION: Non-traumatic abdominal emergencies are extremely prevalent. Hence, the importance of having updated and comparative data on the mortality rate, number of hospitalization and cost generated by these diseases to provide better healthcare services in public hospitals.

RESUMO OBJETIVO: Avaliar a evolução da Incidência, mortalidade e custo das urgências abdominais não traumáticas atendidas nos serviços de emergência do Brasil durante o período de nove anos. MÉTODOS: Este trabalho utilizou informações do DataSus de 2008 a 2016, (http://www.tabnet.datasus.gov.br). Foram analisados número de internações, valor médio das internações (AIH), valor total das internações, dias de permanência hospitalar e taxa de mortalidade das seguintes doenças: apendicite aguda, colecistite aguda, pancreatite aguda, diverticulite aguda, úlcera gástrica e duodenal, e doença inflamatória intestinal. RESULTADOS: A doença que teve o maior crescimento do número de internações foi a doença diverticular do intestino, com o valor de 68,2%. Ao longo dos nove anos não houve grandes variações da média de permanência hospitalar, sendo que o maior aumento foi o da úlcera gástrica e duodenal, com crescimento de 15,9%. A taxa de mortalidade da doença por úlcera gástrica e duodenal teve um aumento de 95,63%, consideravelmente significante quando comparada com as outras doenças. Todas tiveram seus valores de AIH aumentados, porém, a que proporcionalmente teve o maior aumento nos últimos nove anos foi a úlcera gástrica e duodenal, com um acréscimo de 85,4%. CONCLUSÃO: As urgências abdominais de origem não traumática são de extrema prevalência, por isso a importância em ter dados atualizados e comparativos sobre a taxa de mortalidade, o número de internações e os custos gerados por essas doenças, para melhor planejamento dos serviços públicos de saúde.

Helicobacter pylori, úlcera péptica y cáncer gástrico / Helicobacter pylori, peptic ulcer and gastric cancer

Resumen Introducción. Por lo general, se ha descrito que la localización duodenal de la úlcera es más frecuente que la localización gástrica; sin embargo, en áreas con alta incidencia de cáncer gástrico la úlcera péptica parece tener una distribución anatómica distinta, existiendo predominio de la localización gástrica. Objetivo. Realizar una revisión narrativa de la literatura acerca de la distribución anatómica de la úlcera péptica en áreas con alta y baja incidencia de cáncer gástrico. Materiales y métodos. Se realizó una búsqueda estructurada de la literatura en las bases de datos ProQuest, EBSCO, ScienceDirect, PubMed, LILACS, Embase, Trip, SciELO y Cochrane Library con los términos "Peptic ulcer" AND "stomach neoplasm"; la búsqueda se hizo en inglés con sus equivalentes en español y se limitó a estudios observacionales, cohortes y casos y controles. Resultados. Se encontraron alrededor de 50 artículos con información relevante para la presente revisión. Conclusión. La literatura disponible sugiere que la úlcera péptica predomina en áreas donde el cáncer gástrico tiene alta incidencia, mientras que en zonas donde la incidencia de la neoplasia es baja predomina la localización duodenal.

Abstract Introduction: In general, ulcers are more frequently observed in the duodenum than in the stomach. However, in areas with a high incidence of gastric cancer, peptic ulcers seem to have a different anatomical distribution, predominantly gastric localization. Objective: To perform a narrative literature review about the anatomical distribution of peptic ulcers in areas with high and low incidence of gastric cancer. Materials and methods: A structured literature search was performed in the ProQuest, EBSCO, ScienceDirect, PubMed, LILACS, Embase, Trip, SciELO and Cochrane Library databases using the terms "Peptic ulcer" AND "Stomach Neoplasm". The search was done in English with its equivalents in Spanish and was limited to observational studies, cohorts and cases and controls. Results: About 50 articles with relevant information for this review were retrieved. Conclusion: The available literature suggests that peptic ulcers predominate in areas where gastric cancer has a high incidence, while duodenal localization predominates in areas where the incidence of neoplasms is low.

Seroprevalencia de infección por Helicobacter pylori en población adulta de Lima, Perú 2017 / Seroprevalence of Helicobacter pylori infection among an adult population of Lima, Peru 2017

Objetivo: Conocer la seroprevalencia de infección por Helicobacter pylori en población adulta de Lima, Perú 2017. Materiales y métodos: Estudio descriptivo, prospectivo, transversal. Población conformada por voluntarios mayores de 18 años, de ambos sexos, con o sin molestias gastroenterológicas generales. Campaña de despistaje realizada en los distritos de Magdalena y Chorrillos de la ciudad de Lima, Perú en el mes de enero del 2017. Para el diagnóstico se utilizó la prueba rápida OnSite H. pylori Ab Combo Rapid Test CE de CTK Biotech. Resultados: Se evaluó a 140 pacientes, edad media 36.6 años, 22.1% de sexo masculino y 77.9% de sexo femenino. La seroprevalencia para Helicobacter pylori fue 63.6%. Conclusiones: Nosotros concluimos que la infección por Helicobacter pylori es frecuente en el área de la ciudad de Lima, sin diferencia entre género y edad

Objective: To know the seroprevalence of Helicobacter pylori infection among an adult population of Lima, Peru 2017. Materials and methods: Descriptive, prospective, cross-sectional study. Population of volunteers older than 18 years, of both sexes, with or without general gastrointestinal discomfort. A screening campaign was carried out in the districts of Magdalena and Chorrillos in the city of Lima, Peru, in January 2017. For the diagnosis, CTK Biotech's OnSite H. pylori Ab Combo Rapid Test CE was used. Results: One hundred forty (140) patients were evaluated, with a mean age of 36.6 years old, being 22.1% male and 77.9% female. The seroprevalence of Helicobacter pylori infection was 63.6%. Conclusions: We conclude that Helicobacter pylori infection is common in the city of Lima, with no difference between gender and age

Penetrating gastric ulcer as a manifestation of multisystemic tuberculosis / Úlcera gástrica penetrante como manifestación de tuberculosis multisistémica

We present the case of a 30-year old female with a history of abdominal pain, fever, poor oral tolerance and weight loss for 6 months. An abdominal CT scan showed marked gastric dilatation due to extrinsic compression from lymphadenopathies around the second portion of the duodenum. The upper endoscopy revealed the presence of a penetrating gastric ulcer in the greater curvature. Biopsies of the lesions showed hystiocytes with granulomatous features and Acid Fast Bacilli (AFB) positive, and the cultures grew Mycobacterium tuberculosis sensitive to Isonazid and Rifampin. Subsequently anti-TB regimen was initiated achieving great clinical and endoscopic improvement.

Se presenta un caso de una mujer de 30 años de edad con historia de dolor abdominal, fiebre, poca tolerancia oral y pérdida de peso por 6 meses. Un CT scan abdominal muestra dilatación marcada gástrica debido a una compresión extrínseca por adenopatías alrededor de la segunda porción del duodeno. Una endoscopía alta revela la presencia de una úlcera gástrica penetrante en la curvatura mayor. Las biopsias mostraron histiocitos con granulomatosis y bacilos acid fast positivos y en los cultivos crecieron micobacterium tuberculosis sensibles a isoniacidad y rifampicina. Subsecuentemente se inició el régimen anti TBC lográndose una mejoría clínica y endoscópica evidente.