ABSTRACT
CONTEXT: The association between Helicobacter pylori infection and colon neoplasia has been the subject of recent investigations which have produced controversial results. OBJECTIVE: To evaluate the prevalence of H. pylori infection in patients with colonic adenomas and also in patients whose colonoscopy exams were normal. METHODS: After colonoscopy, the individuals were distributed into two groups: patients with colon adenomas (cases) and patients whose colons were normal (controls). The groups were similar regarding age and gender. The individuals of both groups were subjected to a dosage of IgG antibody against H. pylori. The dosage was applied according to the solid phase, chemiluminescent immunometric assay. The chi-square test was used to analyze the data. RESULTS: There were 30 men and 64 women in each group (94 cases and 94 controls). The mean age of the cases was 59.79 ± 12.25 years and that of the controls was 58.98 ± 11.55 years. The H. pylori serology was positive for 66 (70.21 percent) of the cases and for 51 (54.25 percent) of the controls. There was a significant difference (P = 0.024). The odds ratio was 1.98 (CI 95 percent, 0.82-3.15). The prevalence of H. pylori in cases and controls according to gender, histological type and location of the colon lesions showed a significant difference only among women (P = 0.03), among patients with tubular adenomas (P = 0.03), and in those with distal adenomas (P = 0.038). CONCLUSION: There is a positive association between H. pylori infection and colonic adenomas. This association is more evident in women, especially for tubular adenomas and distal colonic location.
CONTEXTO: A associação entre a infecção pelo Helicobacter pylori e as neoplasias de cólon tem motivado alguns estudos recentes, porém os resultados ainda são controversos. OBJETIVO: Avaliar a prevalência da infecção pelo H. pylori em pacientes com adenomas colônicos e naqueles com cólons normais à colonoscopia. MÉTODOS: Após as colonoscopias, distribuíram-se os indivíduos em dois grupos: pacientes com adenomas de cólon (casos) e pacientes com cólons normais (controles), pareados por idade e sexo. Em ambos os grupos, realizou-se dosagem sérica de IgG contra o Helicobacter pylori através de ensaio imunométrico quimioluminescente em fase sólida. Os dados foram analisados pelo teste do qui ao quadrado. RESULTADOS: Foram 94 casos e 94 controles, 30 homens e 64 mulheres em cada grupo. A idade média dos casos e controles foi de 59,79 ± 12,25 anos e 58,98 ± 11,55 anos, respectivamente. A sorologia para Helicobacter pylori foi positiva em 66 (70,21 por cento) casos e em 51 (54,25 por cento) controles, diferença estatisticamente significativa (P = 0,024). O "odds ratio" foi de 1,98 (CI 95 por cento, 0,82 - 3,15). A prevalência de Helicobacter pylori em casos e controles de acordo com o sexo, tipo histológico e localização das lesões no cólon somente apresentou diferença significativa entre as mulheres (P = 0,03), pacientes com adenomas tubulares (P = 0,03) e naqueles com adenomas distais (P = 0,038). CONCLUSÕES: Há associação positiva entre a infecção pelo H. pylori e os adenomas colônicos. Esta relação é mais evidente em mulheres, em adenomas tubulares e de localização colônica distal.
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Adenoma/microbiology , Colonic Neoplasms/microbiology , Helicobacter pylori , Helicobacter Infections/epidemiology , Antibodies, Bacterial/blood , Biomarkers , Brazil/epidemiology , Case-Control Studies , Hospitals, University , Helicobacter Infections/complications , Helicobacter Infections/diagnosis , Helicobacter pylori/immunology , Immunoassay , Immunoglobulin G/blood , Prevalence , Seroepidemiologic Studies , Young AdultABSTRACT
Se presenta el caso de un paciente, hombre de 74 años, portador de hipertensión arterial crónica y diabetes mellitus Tipo 2, portador de un cáncer de colon derecho recientemente diagnosticado y que tenía planificada cirugía electiva. Es ingresado de urgencia al Hospital del Salvador por un cuadro de calofríos y fiebre alta de tres días de evolución, cuyo estudio descartó foco séptico pulmonar, urinario y otros, incluyendo Ecocardiograma para descartar una endocarditis. Solo se demostraron dos hemocultivos positivos para Streptococcus anginosus, siendo tratado exitosamente con Ceftriaxona y Metronidazol. Es intervenido quirúrgicamente al 7º día, encontrándose un tumor abscedado de colon derecho. Evolución postoperatoria satisfactoria, siendo dado de alta al 5º día del postoperatorio.
We report a 74 years old hypertensive and diabetic male with a recently diagnosed right colon cancer that consulted in the emergency room for fever and chills lasting three days. He was admitted, two blood cultures were positive for Streptococcus anginosus, treatment with Ceftriaxone and Metronidazole was started and fever subsided after four days of treatment. The surgical exploration showed that the colon cancer was abscessed and was the origin of the sepsis. The patient was discharged in good conditions five days later.
Subject(s)
Humans , Male , Aged , Streptococcal Infections/complications , Streptococcal Infections/diagnosis , Colonic Neoplasms/surgery , Colonic Neoplasms/microbiology , Sepsis , Abscess , Ceftriaxone/therapeutic use , Streptococcal Infections/drug therapy , Metronidazole/therapeutic use , Streptococcus anginosus/isolation & purification , Treatment OutcomeABSTRACT
Tuberculosis and carcinoma of the colon rarely coexist. We report 2 such cases and review the available literature. Since the potential for misdiagnosis is high in such patients and a preoperative diagnosis of coexistence is usually not possible, important questions regarding the management of patient with a diagnosis of either colonic cancer on tuberculosis need to be addressed.
Subject(s)
Adenocarcinoma/microbiology , Adult , Aged , Colonic Neoplasms/microbiology , Female , Humans , Intestinal Obstruction/etiology , Male , Tuberculosis, Gastrointestinal/complicationsABSTRACT
Campylobacter fetus subsp. intestinalis was isolated from the blood of two different patients. One patient was a 46-year-old male with liver cirrhosis and the other a 44-year-old male with co1on carcinoma. These are the second and third documented infections of this kind in Korea. Difficulties of their isolation were well illustrated. For instance, the growth was detected after a long incubation of 4 to 6 days. All of the 3 blood cultures from the carcinoma patient, but on1y 2 of 3 specimens from the other patient, yielded the organism.