An overview of malaria transmission from the perspective of Amazon Anopheles vectors

In the Americas, areas with a high risk of malaria transmission are mainly located in the Amazon Forest, which extends across nine countries. One keystone step to understanding the Plasmodium life cycle in Anopheles species from the Amazon Region is to obtain experimentally infected mosquito vectors. Several attempts to colonise Ano- pheles species have been conducted, but with only short-lived success or no success at all. In this review, we review the literature on malaria transmission from the perspective of its Amazon vectors. Currently, it is possible to develop experimental Plasmodium vivax infection of the colonised and field-captured vectors in laboratories located close to Amazonian endemic areas. We are also reviewing studies related to the immune response to P. vivax infection of Anopheles aquasalis, a coastal mosquito species. Finally, we discuss the importance of the modulation of Plasmodium infection by the vector microbiota and also consider the anopheline genomes. The establishment of experimental mosquito infections with Plasmodium falciparum, Plasmodium yoelii and Plasmodium berghei parasites that could provide interesting models for studying malaria in the Amazonian scenario is important. Understanding the molecular mechanisms involved in the development of the parasites in New World vectors is crucial in order to better determine the interaction process and vectorial competence.

Estudio por manometría esofágica de pacientes con enfermedad por reflujo gastroesofágico, en Cuba / Esophagel manometry study of patients with gastroesophageal reflux disease, in Cuba

La Enfermedad por Reflujo Gastroesofágico es el resultado de varias situaciones, con un desequilibrio entre los factores defensivos y la integridad de la barrera antirreflujo. El diagnóstico se realiza por los elementos clínicos, la endoscopia, la histología y la pHmetría esofágica. La Manometría Esofágica nos permite co- nocer el estado de la barrera antirreflujo y los trastornos motores se asocian a estos pacientes, que facilitan el desarrollo de la enfermedad. En este trabajo se estudian las características de los factores de motilidad, a través de la manometría esofágica, en un grupo de pacientes, con Enfermedad por Reflujo Gastroeso fágico.

Gastroesophageal Reflux Disease is the result of several situations, with an imbalance between the defensive factors, and the integrity of the antireflux barrier. Diagnosis is made by clinical, endoscopy, histology and esophageal pHmetry. Esophageal manometry allows us to understand the behavior of this barrier and the disease´s development. In this paper, we study the charactequeristics of motility factors, by esophageal manometry, in a group of patients with Gastroesophageal Reflux Disease.

Helicobacter pylori: efectividad del tratamiento secuencial vs tratamiento convencional / Helicobacter pylori: effectiveness of conventional treatment versus sequential treatment

Helicobacter pylori (Helicobacter p.) es una bacteria que se aloja a nivel de la mucosa gástrica la cual presenta una prevalencia variable y está asociada al desarrollo de úlceras pépticas, linfomas y cáncer gástrico. Aproximadamente el 40% de los individuos en países desarrollados están afectados y hasta un 85%, en los países subdesarrollados, por ello, se asocia con un bajo nivel socioeconómico. Recientemente se ha propuesto el uso de una terapia secuencial con el objetivo de erradicar la infección por Helicobacter p. El objetivo de este estudio consiste en comparar la efectividad de ambos tratamientos en la consulta del Servicio de Gastroenterología del Hospital “Carlos J. Bello” en el período de febrero 2008 a octubre 2009, en un total de 83 pacientes, 77,1% de sexo femenino, y 22,9% de sexo masculino. El grupo que recibió tratamiento convencional representó el 57,83%, del total de pacientes estudiados, y el grupo que recibió tratamiento secuencial, representó el 42,17%. En cuanto a la efectividad, el tratamiento convencional fue efectivo en un 46,99%, y el secuencial en un 32,53%, dentro de su propio grupo de pacientes. La prueba X2 no representó diferencia significativa entre la efectividad de ambos tratamientos.

Helicobacter pylori (Helicobacter p. ) Its a bacteria that lives in the gastric mucosa and its prevalence is variable and it is associated to the development of peptic ulcer, lymphoma, and gastric cancer. Approximately 40% of individuals in developed countries are affected and 85% in undeveloped countries in which are related to low socioeconomics level. Recently its been proposed the use of a sequential therapy to eradicate the infection by Helicobacter p. The objective of this study consist in to compare the effectiveness between both treatments (Sequential and conventional) in the consult from the Gastroenterology Service of the Carlos J. Bello Hospital in a period of time between February 2008 to October 2009 in a total of 83 patients, 77,1% feminine, 22,9% masculine. The group that received conventional treatment represented 57,83% and sequential 42,17%. In regard to the effectiveness the conventional group presented 46, 99% and sequential group 32, 53%. The X2 test it didn’t present significative difference of effectiveness between both treatments.

Proinflammatory cytokines and thrombomodulin in patients with peptic ulcer disease and gastric cancer, infected with Helicobacter pylori.

Backgrounds: Helicobacter pylori infect more than half of the global population. It is suggested to be related with gastritis, peptic ulcer disease (PUD), and gastric cancer. Aims: The aim of this present study was to evaluate proinflammatory cytokines including interleukin 1, 6, 8, 10, and thrombomodulin in H. pylori-infected patients with PUD and gastric cancer. Patients: This cross-sectional study was conducted in Taleghani Hospital on 111 patients with H. pylori infection. Materials and Methods: Patients were divided into three groups of PUD, cancer, and control (normal on endoscopy), according to the results of endoscopy. The serum levels of interleukins 1, 6, 8, and 10 and thrombomodulin was determined using enzyme-linked immunosorbent assay (ELISA) technique. H. pylori infection was diagnosed by histological examination of the endoscopic biopsy. Results: One hundred eleven patients were included in the study; 30 as PUD group, 30 as gastric cancer group, and 51 as controls. There was no significant difference between the means of IL-1 and IL-10 levels among the three groups (P = 0.744 and 0.383, respectively). IL-6, IL-8, and thrombomodulin levels were found to be statically different among the three groups (P < 0.05). The level of IL-6, IL-8, and thrombomodulin in cancer group was significantly higher than PUD and control groups (P < 0.05). Conclusion: There is a significant association between H. pylori infection and serum IL-6, IL-8, and thrombomodulin but such relation is not present between H. pylori and IL-1 and IL-10. Immunity response (IL-6, IL-8 and thrombomodulin) is more severe in cancer patient than PUD.

Diagnóstico tardio da imunodeficiência comum variável / Late diagnosis of common variable immunodeficiency

A imunodeficiência comum variável (ICV) é uma doença primária do sistema imunológico associada a infecções recorrentes, principalmente no trato respiratório, fenômenos autoimunes e neoplasias. Sua incidência é relativamente baixa, mas é considerada entre as imunodeficiências primárias sintomáticas a mais comum; mesmo assim o atraso no seu diagnóstico costuma ser muito frequente. Os autores apresentam um caso de um paciente com diagnóstico prévio de anemia perniciosa que apresentava infecções respiratórias de repetição quando o diagnóstico de ICV foi suspeitado

Common variable immunodeficiency (CVID) is a primary disease of the immune system, associated with recurrent infections, mainly in the respiratory tract, autoimmune phenomena and malignancies. Although its incidence is relatively low, it is considered the most common among symptomatic primary immunodeficiencies. Still, the delay in diagnosis is very frequent. The authors present a case of a patient with previous diagnosis of pernicious anemia who presented with recurrent respiratory infections when the diagnosis of CVID was suspected

Tratamento cirúrgico da estenose pilórica / Surgical treatment of pyloric stenosis

Úlcera péptica é definida como uma lesão de mucosa gástrica e/ou duodenal que ocorre quando há desequilíbrio entre fatores de proteção e agressão. É um dos maiores problemas de saúde, com incidência em torno de 1.500 a 3.000 casos a cada 100.000 habitantes por ano. Atualmente, a cirurgia eletiva para essa doença está virtualmente excluída, reservando-se apenas para casos de emergência. A grande maioria desses procedimentos consiste em rafia da parede gástrica ou duodenal por úlcera perfurada. A hemorragia dessas lesões aparece como segunda complicação mais frequente. E, finalmente, apenas cerca de 1 a 2% dos pacientes necessitam de tratamento cirúrgico para aliviar uma obstrução gástrica ou duodenal, já que o processo ulceroso crônico deixa fibrose e estenose na região. No presente estudo, são relatados 3 casos em nossa instituição em que executamos cirurgia devido à estenose péptica do piloro e duodeno refratária ao tratamento clínico num período menor que 8 meses. Em todos os casos, foi realizada uma hemigastrectomia, com reconstrução à Y de Roux, obtendo resultados satisfatórios

Peptic ulcer is defined as injury to the gastric or duodenal mucosa which occurs when there is an imbalance between protective factors and aggression to it. It is one of the biggest health problems, with an incidence of around 1500 to 3000 cases per 100,000 people per year. Currently, elective surgery for this disorder is virtually excluded, reserved for emergency cases only. The vast majority of these surgical procedures consists in suturing the stomach or duodenal wall with perforated ulcer. Hemorrhage from these lesions appears as the second most frequent complication. And finally, only about 1-2% of patients require surgery to relieve a gastric or duodenal obstruction, since the chronic ulcerous process causes fibrosis and ulcerative stenosis in the region. In the present study we report three cases in which we performed surgery due to peptic stenosis of the pylorus and duodenum refractory to medical treatment in a period less than 8 months. In all cases, hemigastrectomy with Roux-Y reconstruction was performed, with satisfactory results

Infección por Helicobacter pylori en pacientes sintomáticos con patología gastroduodenal benigna: análisis de 5.664 pacientes / Helicobacter pylori infection in symptomatic patients with benign gastroduodenal diseases: analysis of 5.664 cases

Infection with Helicobacter pylori (H. pylori) is highly prevalent in Chile, but there are no systematic studies in patients with upper gastrointestinal symptoms. Aim: To determine the prevalence of H. pylori infection, according to age, gender and endoscopic pathology in a large sample of patients. Methods: We studied 7,893 symptomatic patients submitted to upper gastrointestinal endoscopy between July 1996 and December 2003 in the context of a screening program of gastric cancer in a high risk population. H. pylori infection was determined by rapid urease test (RUT) in antral mucosa. We excluded 158 patients with gastric cancer (2 percent) and 2,071 patients without RUT. Results: We included 5,664 patients, mean age 50.7 ± 13.9 years, women 72.1 percent. Endoscopic diagnoses were normal in 59.3 percent, erosive esophagitis in 20 percent, gastric ulcer (GU) in 8.1 percent, duodenal ulcer (DU) in 6.4 percent, and erosive gastropathy in 6.2 percent. RUT was positive in 78 percent of patients. After adjusting for age and sex and with respect to patients with normal endoscopy, frequency of H. pylori infection was 86.6 percent in DU (OR 2.1, 95 percent CI 1.5-2.8, p < 0.001); 81.4 percent in GU (OR 1.8, 95 percent CI 1.4-2.4; p < 0.001 ); 79.9 percent in erosive gastropathy (OR 1.4, 95 percent CI 1.03-1.8; p = 0.03) and 77.4 percent in erosive esophagitis (OR 1.1, 95 percent CI: 0.9-1.3; p = NS). The probability of H. pylori infection decreased significantly with age, more markedly in men with normal endoscopy. Conclusions: Prevalence of H. pylori infection is very high in symptomatic Chilean patients and even higher in those with gastroduodenal ulcer or erosions, while in patients with erosive esophagitis is similar to those with normal endoscopy. The frequency of infection decreases with age, probably as a consequence of rising frequency of gastric mucosal atrophy.

Clinical and pathological importance of vacA allele heterogeneity and cagA status in peptic ulcer disease in patients from north Brazil

We have examined the prevalence of gene cagA and vacA alleles in 129 patients, 69 with gastritis and 60 with peptic ulcer diseases from North Brazil and their relation with histopathological data. vacA and cagA genotype were determined by polymerase chain reaction. Hematoxylin-eosin staining was used for histological diagnosis. 96.6 percent of the patients were colonized by Helicobacter pylori strains harboring single vacA genotype (nont-mixed infection). Among them, 11.8 percent had subtype s1a, 67.8 percent had subtype s1b, and 17 percent subtype s2. In regard to the middle region analysis, m1 alleles were found in 75.4 percent and m2 in 21.2 percent of patients. The cagA gene was detected in 78 percent patients infected with H. pylori and was associated with the s1-m1 vacA genotype. The H. pylori strains, vacA s1b m1/cagA-positive, were associated with increased risk of peptic ulcer disease and higher amounts of lymphocytic and neutrophilic infiltrates and the presence of intestinal metaplasia. These findings show that cagA and vacA genotyping may have clinical relevance in Brazil.

Avaliação tardia de doentes gastrectomizados por úlcera péptica: aspectos clínicos, endoscópicos e histopatológicos / Late follow-up of gastrectomized patients for peptic ulcer: clinical, endoscopic and histopathological aspects

RACIONAL: Atualmente são raras as vezes em que é necessária a realização de uma gastrectomia, já que os inibidores da bomba de prótons associados aos esquemas antibióticos usados para erradicar o Helicobacter pylori, mudaram o enfoque do tratamento da úlcera péptica. OBJETIVOS: Avaliar tardiamente os doentes submetidos a gastrectomia parcial no tratamento da úlcera péptica, em época em que o Helicobacter pylori ainda não era erradicado de forma intencional, incluindo os sintomas pós-operatórios em comparação com os pré-operatórios e a incidência de síndromes pós-gastrectomias; avaliação endoscópica, incluindo o tipo de cirurgia realizada e os achados macroscópicos da mucosa do coto gástrico, duodeno ou jejuno, dependendo do tipo de reconstrução; avaliação histopatológica, incluindo a pesquisa da bactéria por dois métodos: histológico e teste de urease; e sua possível associação presente no estômago remanescente com as avaliações clínica, endoscópica e histopatológica pós-operatórias. CASUíSTICAS E MÉTODOS: Cinqüenta e nove doentes gastrectomizados por úlcera péptica entre os anos de 1985 e 1993 foram avaliados, sendo que 44 (74,6 por cento) eram do sexo masculino e tinham idade média de 55 anos, com variação de 31 a 77 anos, passaram por entrevista clínica e por exame endoscópico. O Helicobacter pylori foi pesquisado nas peças cirúrgicas ressecadas, para constatação da sua presença ou não no pré-operatório. RESULTADOS: A avaliação clínica no pós-operatório tardio mostrou que 96 por cento dos doentes apresentaram excelentes e bons resultados (Visick I e II). Os sintomas pós-operatórios mais comuns foram dispepsia leve e outras queixas, como diarréia, anemia e dumping, que ocorreram, respectivamente, em 11 (18,6 por cento), 2 (3,4 por cento) e 2 (3,4 por cento) casos. A reconstrução tipo Billroth I trouxe melhores resultados clínicos tardios, quando comparada com as reconstruções tipo Billroth II e Y-de-Roux. Na avaliação endoscópica, a maioria dos doentes (52,5 por cento) apresentou exame normal, enquanto que os demais apresentaram gastrites enantematosa (37,3 por cento) e erosiva (8,5 por cento). Recidiva ulcerosa ocorreu em dois doentes (3,4 por cento). Na análise histopatológica, foi observada incidência elevada de gastrite crônica (98,3 por cento). A presença de Helicobacter pylori ocorreu em 86 por cento dos doentes antes da cirurgia e em 89,8 por cento no pós-operatório tardio...

Enfermedad ulcerosa péptica / Peptic ulcerative disease

Se llama Síndrome Ulceroso Péptico Tipico, al conjunto de síntomas y signos, caracterizados por dolor urente o quemante localizado en epigastrio, que puede ser transfictivo a dorso, acompañado de sensación de vacio o hambre dolorosa, que aparece con el ayuno y calma con los alimentos no condimentado y que se presenta más o menos periódicamente (primavera, otoño, tension nerviosa).

Ulceras gástricas pépticas / Peptic gastric ulcers

La enfermedad ulcerosa péptica considerada como una enfermedad crónica; caracterizada por frecuentes racídas, muchas veces asintomáticas; no tiene una historia clínica típica. En cuanto a su historia natural tiene un alto índice de recidiva. Puede iniciarse con una complicación. A pesar de ser una patología muy estudiada sigue afectando a millones de personas en todo el mundo. Se detalla en este trabajo los diferentes aspectos de la enfermedad, como la fisiopatología, la clínica, la etipatogenia, los métodos de diagnóstico, los diagnósticos diferenciales, los aspectos histológicos y endoscópicos, las complicaciones y el tratamiento. Se destacan los avances en etiopatogenia, sobre todo en la confirmación de los factores etiológicos fundamentales, como ser, el helicobacter pylori, el consumo de antiinflamatorios no esteroides (AINES) y otros factores no bien demostrados que contribuyen en el desarrollo de la enfermedad. Se demuestra con los datos estadísticos la frecuencua de la patología, y sobre todo la importancia del diagnóstico diferencial entre la élcera péptica gástrica y el adenocarcinoma gástrico. Con la recopilación de informaciones sobre los diferentes aspectos de la úlcera gástrica, este trabajo intenta servir de referente para muchos estudiantes que seguiran investigando acerca de esta entidad nosológica, ya que el trabajo abre un horizonte para revisiones postreras.

Los genotipos de helicobacter pylori en gastritis no atrófica difieren de los encontrados en úlcera péptica, lesiones premalignas y cáncer gástrico en Colombia / Helicobacter pylori genotypes in non atrophic gastritis, peptic ulcer disease, premalignant lesions and gastric cancer in Colombia

Background: Helicobacter pylori is recognized as an etiologic agent of several gastric diseases. Bacterial genotypes have been related to clinical outcome in several populations. Aim: To compare cagA, vacA and iceA genotypes of Colombian isolates from patients with several gastrointestinal diseases, including gastric cancer. Material and methods: We used polymerase chain reactions to amplify vacA, cagA and iceA genes of 137 H pylori isolates coming from 26 patients with gastric cancer (GC), 34 with peptic ulcer (PU), 19 with intestinal metaplasia (IM), 23 with atrophic gastritis (AG) and 35 with non atrophic gastritis (NAG). Results: vacA s1-m1, cagA+, iceA+ were the most frequently found genotypes. vacA s1 and m1 subtypes were found in 92 (67 percent) and 82 (60 percent) cases respectively. Sixty three percent were cagA+ and 85 percent were iceA+. There was a lower prevalence of s1 allele in cases of NAG (43 percent), compared with GC, PU and IM (81 percent, 77 percent and 81 percent prevalence, respectively, p <0.01). Isolates from NAG also showed a low frequency of vacA m1 subtype (40 percent) compared with GC or IM (81 percent and 84 percent respectively, p <0.01). The prevalence of cagA+ strains was significantly higher in GC patients (80 percent) than in NAG patients (51.4 percent, p <0.01). No differences in the frequency of vacA s1a, s1b and iceA subtypes, were observed. Conclusions: A lower frequency of cytotoxic H pylori genotypes such as cagA and vacA s1m1 and a higher frequency of non cytotoxic genotypes, was observed in patients with NAG, when compared to patients with GC or PU. These results suggest that even in Colombia, vacA and cagA could be used as markers of increased virulence

Relevance of vacA Genotypes of Helicobacter pylori to cagA Status and Its Clinical Outcome

BACKGROUND: Determination of vacA mosaicism may be important because specific Helicobacter pylori vacA genotype can be used to predict different clinical outcome. The aim of this study was to assess the relationship of vacA genotypes of Helicobacter pylori to cagA status and its development of peptic ulcer diseases in Korean patients. METHODS: Gastric biopsy specimens were obtained from 53 patients with gastric ulcer(GU), 57 with duodenal ulcer (DU) and 26 with chronic gastritis(CG) patients; all patients were infected with Helicobacter pylori. Bacterial mRNAs in the gastric mucosa were amplified by RT-PCR, using synthetic oligonucleotide primers specific for the vacA and the cagA gene. Patients with vacA s1 subtype were further examined to determine whether they had s1a or s1b subtype. RESULTS: There was no correlation in frequency of vacA s1 and/or s1a genotype between CG and either GU or DU, as the vacA s1 and s1a/m1 were present in the majority of strains independent of clinical status(s1 ; 100.0% versus 94.3 % or 93.0 % and s1a/m1 ; 76.9% versus 62.3% or 64.9%, res pectively). Likewise, there was no difference in the prevalence of the cagA gene between CG and either GU or DU patients (92.3% versus 90.6% or 98.2%, respectively). In addition, the cagA-negative status did not predict the presence of vacA s2 genotype. CONCLUSION: These results strongly suggest that either cagA or vacA s1 and/or s1a is not proved to be a useful marker to distinguish disease-specific Helicobacter pylori strains for the development of peptic ulcer diseases in Korean patients.

Lesiones endoscopicas del tracto digestivo superior en pacientes urémicos / Endoscopy lesions of upper gastrointestinal tract in uremics patients

Se estudia la frecuencia de lesiones endoscópicas del tracto digestivo superior en pacientes urémicos en tratamiento con tres modalidades diferentes: hemodialisis(HD), diálisis peritoneal ambulatoria crónica (DPAC) y tratamiento médico (no dialítico). Los tres grupos estudiados totalizaban 27 pacientes, distribuidos de la siguiente forma: 11 pacientes en HD, 9 en DPAC y 7 en tratamiento médico, todos estaban en control médico en los Servicios de Medicina Interna y Nefrología del Hospital "Antonio María Pineda" de la ciudad de Barquisimeto. El estudio, de tipo prospectivo, fue realizado entre los meses de noviembre de 1993 y julio de 1994. La selección de los pacientes fue realizada al azar. Los tres grupos estudiados no diferían de forma significativa en cuanto a edad, sexo, sintomatología digestiva previa, enfermedad concomitante o datos paraclínicos (hemoglobina, hematocrito, úrea, creatinina, calcio, fósforo, sodio y potasio sérico). Todos los pacientes fueron sometidos a endoscopia digestiva superior, encontrándose que las lesiones más frecuentes fueron la úlcera duodenal y la doble lesión gastro-duodenal. El grupo de tratamiento más afectado fue el de hemodiálisis. Del presente estudio puede concluirse que las lesiones gastroduodenales son muy frecuentes en los pacientes urémicos y que la endoscopia digestiva superior debería realizarse de forma periódica y regular a todos los pacientes urémicos, aun a aquellos sin síntomas digestivos previos.

Seguimiento terapeutico de pacientes con Helicobacter pylory / Therapeutic follow up of patients with Helicobacter pylori

Se estudian 121 pacientes con antecedentes clinicos conocidos y se someten a endoscopia alta con biopsia transendoscopica para diagnostico histologico de lesion gastrica y deteccion de helicobacter pylori. El 76 por ciento tenian positividad para helicobacter pylori, a quienes se inicia tratamiento bi y/o triasociado para su erradicacion utilizando Amoxilina + Omeprazol a diferentes dosis, y Amoxicilina + Metronidazol + Subcitrato de Bismuto. Se demuestra la existencia de helicobacter pylori en la poblacion general, asi como el impacto de la terapia sobre la supresion de los signos y sintomas. Con el esquema 1 (Amoxicilina 500 mg. TID+Omeprazol 20 mg./dia) se negativizaron el 55.56 por ciento, con el esquema 2 (Amoxicilina 1 gr. TID y Omeprazol 20 mg. BID) se negativizaron el 92.11 por ciento de los pacientes y con el esquema 3 (Amoxicilina 500 mg. TID+Metronidazol 250 mg. TID+Subcitrato de bismuto TID) se negativizo el 95.24 por ciento de los pacientes mostrando la eficacia desde el punto de vista bacteriologico. En cuanto a los sintomas el 79.37 por ciento de los pacientes quedaron asintomaticos luego del tratamiento, mientras que el resto tenia leves a moderadas

Utilización del clotest y pyloriset en la determinación del helicobacter pylori en adultos sanos asintomáticos / Utilization of the clotes and pyloriset in the determination of the helicobacter pylori in asymptomatic healthy adults

El Helicobacter Pylori (Hp) ha sido relacionado con la patogénesis de la gastritis crónica, úlcera péptica, dispepsia no ulcerosa y en los últimos estudios ha sido encontrado en alta prevalencia en poblaciones con riesgo de cáncer gástrico. El propósito del presente estudio es determinar la presencia del Hp, en un grupo de adultos asintomáticos, voluntarios, aparentemente sanos, mediante la utilización de dos pruebas diagnósticas, una prueba serológica para la determinación de anticuerpos IgG anti Hp (Pyloriset) y la prueba de Ureasa (Clotest) relacionándola con el desarrollo de lesiones. Se estudiaron 20 sujetos, a quienes se les tomó muestra de sangre periférica para la determinación del Hp mediante el test de aglutinacion de látex (Pyloriset) y se les realizó endoscopia digestiva superior (EDS) con toma de biopsia gástrica para prueba de Ureasa (Clotest). En 15 adultos (75 por ciento) el clotest fue positivo y en 13 sujetos (65 por ciento) el Pyloriset fue positivo. En 9 personas (47 por ciento) El Hp se evidenció por ambos métodos. En 13 personas (65 por ciento) la EDS fue concluida patológica y todos fueron positivos para el Hp y en los 7 (35 por ciento) que la EDS resultó normal, solo uno resultó negativo para el Hp. En 7 sujetos (35 por ciento) la EDS resulto normal. La presencia del anticuerpo contra el Hp predice alteraciones de la mucosa gástrica como el desarrollo de gastritis crónica, úlcera peptica, y otras patologías. El Clotest es una prueba sencilla, rápida y sensible que nos permite aplicar tratamiento de inmediato. Estos resultados sugieren una alta incidencia de esta bacteria en nuestros trabajadores, lo que justifica estudios endoscópicos altos prospectivos para determinarla

Prevalência dos diferentes tipos de gastrites em pacientes com queixas digestivas altas / Prevalence of types of gastritis in patients with upper dyspeptic symptoms

Biopsias gástricas de múltiplos locais foram examinadas retrospectivamente em 153 pacientes para avaliar presença de gastrite e de bactérias tipo Helicobacter. As gastrites crônicas foram classificadas como gastrite superficial difusa antral, gastrite pós-gastrectomia (de refluxo), gastrite atrófica corporal difusa, e gastrite atrófica multifocal. Em alguns casos, problemas técnicos näo permitiram definir o tipo de gastrite crônica e foram adotados os termos gastrite näo classificada e alteraçöes inflamatórias mínimas para designar tais casos. Em nossa opiniäo, eles representam biopsias superficiais de casos de gastrite difusa antral. Gastrite difusa antral foi encontrada em 60% dos pacientes, seguida da gastrite multifocal, encontrada em 20% dos pacientes. Bactérias tipo Helicobacter foram pesquisadas nas secçöes histológicas coradas por uma técnica modificada de Giemsa. Os típicos bacilos curvos foram vistos no muco gástrico ou intimamente aderidos ao topo das células foveolares ou do epitélio superficial, em 83% dos pacientes. Embora tenhamos notado alta correlaçäo entre atividade da gastrite crônica e infecçäo por bactérias, tal correlaçäo näo pôde se feita entre a atividade e o grau da infecçäo