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Rev. peru. med. exp. salud publica ; 40(3): 348-353, jul. 2023. tab
Article in Spanish | LILACS, INS-PERU | ID: biblio-1522776


Se determinó la presencia de los genotipos de virulencia de Helicobacter pylori y su asociación con las lesiones precursoras de malignidad gástrica y parámetros histológicos en pacientes con síntomas de dispepsia del suroccidente de Colombia. Se realizó reacción en cadena de polimerasa (PCR) para la caracterización genética de vacA, cagA, babA2 y sabA. Se empleó la prueba de chi cuadrado o Fischer para evaluar la asociación de cada genotipo sobre el desenlace clínico. En los pacientes con lesiones precursoras de malignidad gástrica se encontró que el 86,3% presentaron el genotipo vacA s1/m1, el 68,1% cagA+ y los genotipos babA2+ y sabA+ con el 68,8% y 55,8%, respectivamente. También, se demostró la asociación entre los genotipos de virulencia y el grado severo de infiltración de células polimorfonucleares. Además, se encontró una asociación entre la combinación de los genes vacA/cagA, vacA/sabA y babA2/sabA. Este estudio proporciona evidencia acerca de la asociación de los genotipos de virulencia del H. pylori y la inflamación gástrica en pacientes infectados.

The aim of this research was to determine the presence of Helicobacter pylori virulence genotypes and their association with precursor lesions of gastric malignancy and histological parameters in patients with dyspepsia symptoms in southwestern Colombia. Polymerase chain reaction (PCR) was used for the genetic characterization of vacA, cagA, babA2 and sabA. The chi-square or Fischer test were used to evaluate the association between each genotype and the clinical outcome. We found that 86.3% of the patients with precursor lesions of gastric malignancy presented the vacA s1/m1 genotype, 68.1% had the cagA+ genotype and 68.8% and 55.8% had the babA2+ and sabA+ genotypes, respectively. Our results show association between virulence genotypes and severe degree of polymorphonuclear cell infiltration. In addition, we found an association between the combination of vacA/cagA, vacA/sabA and babA2/sabA genes. This study provides evidence about the association of H. pylori virulence genotypes and gastric inflammation in infected patients.

Humans , Male , Female , Adult , Middle Aged , Chi-Square Distribution , Adhesins, Bacterial , Gastritis , Virulence Factors , Inflammation
Chinese Journal of Pediatrics ; (12): 827-832, 2023.
Article in Chinese | WPRIM | ID: wpr-1013182


Objective: To investigate the association between Helicobacter pylori (Hp) virulence factor genotypes and the degree and activity of gastric mucosa pathological changes in pediatric gastroduodenal diseases. Methods: This retrospective cohort study was conducted from May 2020 to October 2020. The frozen strains of Hp, which were cultured with the gastric mucosa of 68 children with gastroscopy confirmed gastroduodenal diseases who visited the children's hospital of Zhejiang University School of Medicine from April 2012 to December 2014, were resuscitated. After extracting DNA from these Hp strains, PCR amplification and agarose gel electrophoresis were performed to determine the detection rate of cytotoxin-associated protein A (cagA),vacuolating cytotoxin A (vacA)(s1a、s1b/s2,m1/m2), outer inflammatory protein A (oipA),blood group antigen binding adhesin (babA),duodenal ulcer promoting protein A (dupA) genes; oipA genes were sequenced to determine the gene status. The patients were divided into different groups according to the findings of gastroscopy and gastric mucosa pathology. The detection rates of various virulence factor genotypes among different groups were compared using χ2 tests or Fisher's exact tests. Results: The 68 Hp strains all completed genetic testing. According to the diagnostic findings of gastroscopy, the 68 cases were divided into 47 cases of superficial gastritis and 21 cases of peptic ulcer. Regarding the pathological changes of gastric mucosa, 8 cases were mild, and 60 cases were moderate and severe according to the degree of inflammation; 61 cases were active and 7 cases inactive according to the activity of inflammation. The overall detection rates of cagA, vacA, vacA s1/m2, functional oipA, babA2, and dupA virulence factor genes were 100% (68/68), 100% (68/68), 94% (64/68), 99% (67/68), 82% (56/68), and 71% (48/68), respectively. In the superficial gastritis group, their detection rates were 100% (47/47), 100% (47/47), 96% (45/47), 98% (46/47), 81% (38/47), and 70% (33/47), respectively; in the peptic ulcer group, their detection rates were 100% (21/21), 100% (21/21), 90% (19/21), 100% (21/21), 86% (18/21), and 71% (15/21), respectively. There was no statistically significant difference between the two groups (all P>0.05). In the mild gastric mucosa inflammation group, the detection rates of the above six genotypes were 8/8, 8/8, 8/8, 7/8, 7/8, and 5/8, respectively; and in the moderate to severe inflammation groups, the detection rates were 100% (60/60), 100% (60/60), 93% (56/60), 100% (60/60), 82% (49/60), and 72% (43/60), respectively, with no statistically significant difference between the two groups (all P>0.05). In the active inflammation group, the detection rate of six genotypes were 100% (61/61), 100% (61/61), 93% (57/61), 98% (60/61), 82% (50/61), and 72% (44/61), respectively; and in the inactive inflammation group, they were 7/7, 7/7, 7/7, 7/7, 6/7, and 4/7, respectively. Again, there was no statistically significant difference between the two groups (all P>0.05). There was no statistically significant difference in the detection rate of combinations of 4 or 5 virulence factor genes among the different groups (all P>0.05). Conclusions: CagA, vacA, vacA s1/m2, functional oipA, babA2, and dupA genes are not associated with superficial gastritis and peptic ulcer in children, or with the degree and activity of gastric mucosa pathological inflammation. Different gene combinations of cagA, vacA, oipA, babA2, and dupA have no significant effects on predicting the clinical outcome of Hp infection in children.

Humans , Child , Helicobacter pylori/genetics , Retrospective Studies , Genotype , Inflammation , Gastritis , Cytotoxins
Chinese Medical Journal ; (24): 899-909, 2023.
Article in English | WPRIM | ID: wpr-980859


Eosinophilic gastroenteritis (EGE) is a gastrointestinal disorder of unclear etiology that is characterized by eosinophilic infiltration of the stomach and small intestine, and consists of mucosal, muscular, and serosal subtypes. Eosinophilic infiltration of the gastrointestinal tract is a fundamental histopathological characteristic of EGE and is driven by several T-helper type 2 (Th2)-dependent cytokines and induced by food allergy. Due to the lack of a diagnostic gold standard, EGE has a high rate of delayed diagnosis or misdiagnosis. However, several new diagnostic strategies have been developed, such as novel genetic biomarkers and imaging tests. Although dietary therapy and corticosteroids remain the common choices for EGE treatment, recent decades have seen the emergence of novel treatment alternatives, such as biologics that target particular molecules involved in the pathogenic process. Preliminary investigations and clinical trials have demonstrated the efficacy of biologics and provided additional insights for the era of refractory or corticosteroid-dependent EGE biologics.

Humans , Enteritis/drug therapy , Gastritis/drug therapy , Eosinophilia/therapy , Abdomen , Adrenal Cortex Hormones
Acta Academiae Medicinae Sinicae ; (6): 902-911, 2023.
Article in Chinese | WPRIM | ID: wpr-1008145


Objective To analyze the clinical characteristics of collagenous gastritis (CG) and provide evidence for the precise diagnosis and treatment of CG.Methods Published case reports and case series were collected from PubMed,CNKI,and Wanfang Med Online with the key words of collagenous gastritis,collagenous gastroduodenitis,collagenous gastrointestinal diseases,and gastric mucosal nodules.The demographic and clinical information of each case was collected.Results According to the extent of collagen deposition in the digestive tract,94 CG cases included in this study were assigned into upper digestive tract (UDT)-CG,total digestive tract (TDT)-CG and other groups.The UDT-CG group included 52 cases (57.69% females and 42.31% males) with a median age of 14.50 (11.00,25.75) years old.There were 17 cases in the TDT-CG group,including 70.59% females and 29.41% males,with a median age of 15.00 (9.50,48.50) years old.The other group contained 25 cases,(64.00% females and 36.00% males) with a median age of 25.00 (15.50,59.50) years old.The main clinical manifestations in the UDT-CG group were anemia (59.62%) and diarrhea (17.31%),and those in the TDT-CG group were anemia (29.41%) and diarrhea (94.12%).The nodular appearance of gastric mucosa was observed in 75.00% cases in the UDT-CG group and 35.29% cases in the TDT-CG group.In the initial treatment,symptomatic therapy and hormonal therapy respectively relieved the symptoms in 75.00% (30/40) and 100% (3/3) cases in the UDT-CG group and 57.14% (4/7) and 83.33% (5/6) cases in the TDT-CG group.In the retreatment,symptomatic therapy and hormone therapy respectively achieved the remission rates of 100.00% (3/3) and 88.89% (8/9) in the UDT-CG group and 80.00% (4/5) and 66.67% (2/3) in the TDT-CG group.Conclusions CG,a rare disease of gastric collagen deposition,mainly occurs in young patients,and females are more susceptible than males.The clinical manifestations of CG are nonspecific,and anemia,abdominal pain,diarrhea,weight loss,and gastrointestinal bleeding are the common symptoms of CG.Nodular appearance of gastric mucosa is a relatively specific endoscopic feature of CG.There is no standardized treatment for CG.Symptomatic treatment is commonly adopted to improve the quality of life of the patients,and hormones can be added when necessary.

Male , Female , Humans , Quality of Life , Gastritis/diagnosis , Gastric Mucosa , Collagen , Anemia/etiology , Diarrhea/complications
Arq. ciências saúde UNIPAR ; 26(3): 1248-1266, set-dez. 2022.
Article in Portuguese | LILACS | ID: biblio-1414496


Monteverdia ilicifolia, conhecida popularmente como espinheira-santa, é uma planta da família Celastraceae de relevante ação terapêutica devido às suas propriedades medicinais, principalmente a sua atividade gastroprotetora, possuindo efeitos comprovados sobre acidez e úlceras estomacais. Desta forma o objetivo deste trabalho foi encontrar na literatura evidências para o uso terapêutico da M. ilicifolia, como uma alternativa frente aos fármacos sintéticos disponíveis na indústria farmacêutica voltados para o tratamento de problemas estomacais. Foi utilizado no presente trabalho a base de dados Google acadêmico. Os distúrbios estomacais afetam milhares de pessoas, influenciando de forma negativa na qualidade de vida da população e gerando prejuízos ao sistema de saúde. Os fármacos com atividade sobre a secreção da acidez gástrica são as medicações mais prescritas para essas enfermidades, destacando-se os antagonistas do receptor H2 de histamina e os inibidores da bomba de prótons, amplamente utilizados para o tratamento de úlceras e gastrite. Com o tempo, esses medicamentos passaram a ser indiscriminadamente utilizados, prática que põem em risco a saúde íntegra dos pacientes, mediante aos diversos efeitos adversos que esses medicamentos podem causar. As plantas medicinais têm sido aplicadas na terapia de diversas doenças em toda a história da humanidade. Nesse contexto, a espinheira-santa surge como uma alternativa segura e eficaz para a prevenção e tratamento dessas patologias. Dentre os compostos bioativos que podem desempenhar a atividade gastroprotetora, destacam-se os taninos, triterpenos e flavonóides. Os estudos analisados demonstram que a M. ilicifolia possui relevante ação terapêutica, com potencial para substituir os fármacos usualmente empregados no tratamento de úlceras e gastrite.

The Monteverdia ilicifolia, popularly known as espinheira-santa, is a plant of the Celastraceae's family with relevant therapeutic action due to its medicinal properties, mainly its gastroprotective activity, and possesses proven effects on acidity and stomach ulcers. The aim of this work was to find in the literature evidence for the therapeutic use of M. ilicifolia, as an alternative to the synthetic drugs available in the pharmaceutical industry for the treatment of stomach problems. The academic Google database was used in this work. Stomach disorders affect thousands of people, negatively influencing the population's quality of life and causing damage to the health system. The drugs with activity on gastric acid secretion are the most prescribed medications for these diseases, especially histamine H2 receptor antagonists and proton pump inhibitors, widely used for the treatment of ulcers and gastritis. Over time, these drugs began to be used indiscriminately, a practice that jeopardizes the health of patients, due to the various adverse effects that these drugs can cause. Medicinal plants have been applied in the therapy of various diseases throughout human history. In this context, the espinheira-santa emerges as a safe and effective alternative for the prevention and treatment of these pathologies. Among the bioactive compounds that can perform a gastroprotective activity, tannins, triterpenes, and flavonoids stand out. The analyzed studies demonstrate that M. ilicifolia has relevant therapeutic action, with the potential to replace the drugs usually used in the treatment of ulcers and gastritis.

Monteverdia ilicifolia, conocida popularmente como espinheira-santa, es una planta de la familia Celastraceae de relevante acción terapéutica por sus propiedades medicinales, principalmente su actividad gastroprotectora, con efectos probados sobre la acidez y las úlceras estomacales. Así, el objetivo de este trabajo fue encontrar evidencia en la literatura para el uso terapéutico de M. ilicifolia, como alternativa a las drogas sintéticas disponibles en la industria farmacéutica destinadas al tratamiento de problemas estomacales. En este trabajo se utilizó la base de datos académica de Google. Los trastornos estomacales afectan a miles de personas, influyendo negativamente en la calidad de vida de la población y provocando daños en el sistema de salud. Los fármacos con actividad sobre la secreción ácida gástrica son los más prescritos para estas enfermedades, especialmente los antagonistas de los receptores H2 de histamina y los inhibidores de la bomba de protones, muy utilizados para el tratamiento de úlceras y gastritis. Con el tiempo, estos medicamentos comenzaron a utilizarse de forma indiscriminada, práctica que pone en riesgo la salud de los pacientes, debido a los diversos efectos adversos que estos fármacos pueden ocasionar. Las plantas medicinales se han aplicado en la terapia de diversas enfermedades a lo largo de la historia humana. En este contexto, la espinheira-santa surge como una alternativa segura y eficaz para la prevención y el tratamiento de estas patologías. Entre los compuestos bioactivos que pueden realizar actividad gastroprotectora destacan los taninos, los triterpenos y los flavonoides. Los estudios analizados demuestran que M. ilicifolia tiene una acción terapéutica relevante, con potencial para reemplazar los fármacos habitualmente utilizados en el tratamiento de úlceras y gastritis.

Plants, Medicinal/drug effects , Celastraceae/drug effects , Therapeutic Uses , Stomach Ulcer/drug therapy , Plant Roots , Plant Leaves , Gastric Acid , Gastritis/drug therapy
Rev. colomb. gastroenterol ; 37(2): 220-224, Jan.-June 2022. tab, graf
Article in English | LILACS | ID: biblio-1394953


Abstract Autoimmune gastritis is an underdiagnosed disease in the pediatric population due to the absence of specific signs and symptoms and late clinical manifestations. Iron deficiency anemia has recently been identified as an early hematological manifestation, allowing an early diagnostic approach. We present the case of a Colombian teenager, with no history of autoimmunity, with refractory iron deficiency. He underwent extension studies; biopsies and serology compatible with autoimmune gastritis were documented, requiring parenteral iron in its evolution. This pathology is underdiagnosed in our context since early diagnosis requires a high index of suspicion to prevent associated complications.

Resumen La gastritis autoinmune es una enfermedad subdiagnosticada en la población pediátrica. Lo anterior se debe a la ausencia de signos y síntomas específicos y manifestaciones clínicas tardías. Recientemente se ha identificado la anemia ferropénica como una manifestación hematológica precoz, lo que permite un enfoque diagnóstico temprano. Se presenta el caso de un adolescente colombiano, sin antecedentes de autoinmunidad, con ferropenia refractaria, en el que se realizaron estudios de extensión y se documentaron biopsias y serología compatible con gastritis autoinmune, con requerimiento de hierro parenteral en su evolución. Esta patología es subdiagnosticada en nuestro medio, ya que el diagnóstico temprano requiere un alto índice de sospecha, lo que permite la prevención de las complicaciones asociadas.

Humans , Male , Adolescent , Autoimmune Diseases/diagnosis , Anemia, Iron-Deficiency/diagnosis , Gastritis/diagnosis , Autoimmune Diseases/pathology , Biopsy , Endoscopy, Digestive System , Early Diagnosis , Gastric Mucosa/pathology , Gastritis/pathology
Rev. Méd. Inst. Mex. Seguro Soc ; 60(2): 236-241, abr. 2022. ilus
Article in Spanish | LILACS | ID: biblio-1367401


Introducción: la gastritis enfisematosa es una patología poco común pero con alta mortalidad, su presentación clínica es insidiosa, la imagen por tomografía se distingue por un patrón de burbujas lineales con engrosamiento de la pared gástrica. Caso clínico: paciente masculino de 78 años, previamente sano, funcional, que fue ingresado por fractura pertrocantérica de cadera izquierda, quien durante la hospitalización presenta delirium hiperactivo, distención abdominal con disminución de perístalsis además de hipotensión arterial, se realiza tomografía abdominal con evidencia de dilatación gástrica y múltiples burbujas de aire en pared. Es manejado con antibiótico de amplio espectro, fluidoterapia y nutrición parenteral, con respuesta favorable.Conclusiones: la edad avanzada no conlleva por sí misma un peor pronóstico de la enfermedad, la evidencia apoya que un diagnóstico precoz y la intervención terapéutica temprana, son las medidas que han demostrado ser efectivas para la disminución de la mortalidad en pacientes con gastritis enfisematosa

Introduction: Emphysematous gastritis is an uncommon pathology but with high mortality, its clinical presentation is insidious, the tomography image is distinguished by a pattern of linear bubbles with thickening of the gastric wall.Background: This is a 78-year-old male, previously healthy, functional, who was admitted for pertrochanteric fracture of the left hip, who during hospitalization presented hyperactive delirium, abdominal distention with decreased perstalsis in addition to arterial hypotension, an abdominal tomography with evidence of gastric dilation and multiple air bubbles in the wall. He is managed with a broad spectrum antibiotic, fluid therapy and parenteral nutrition, with a favorable response.Conclusions: Advanced age does not in itself lead to a worse disease prognosis, the evidence supports that early diagnosis and early therapeutic intervention are the easures that have proven to be more effective in reducing mortality in patients with emphysematous gastritis.

Humans , Male , Aged , Emphysema/diagnostic imaging , Gastritis/diagnostic imaging , Gastric Dilatation/diagnostic imaging , Parenteral Nutrition , Emphysema/therapy , Gastritis/therapy , Anti-Bacterial Agents/administration & dosage
Med. UIS ; 35(1): 31-42, ene,-abr. 2022. tab, graf
Article in Spanish | LILACS | ID: biblio-1394430


Resumen La infección por Helicobacter pylori se asocia con enfermedades gastroduodenales como gastritis crónica, úlcera péptica y adenocarcinoma gástrico. Actualmente se dispone de diferentes esquemas terapéuticos, sin embargo, el uso indiscriminado de antibióticos generó resistencia en este agente, razón para estudiar alternativas y reevaluar los criterios que determinan la selección de un esquema en específico. El objetivo de esta revisión fue describir los principios generales de tratamiento de acuerdo a guías de referencia y recomendaciones de autores independientes, y exponer el uso de la rifabutina como alternativa terapéutica. En la búsqueda bibliográfica se usaron los términos "Helicobacter pylori" AND "rifabutin", en las bases de datos PubMed, SciELO y el motor de búsqueda Google Scholar®. La evidencia actual sugiere que el uso de rifabutina como terapia de rescate es apropiado y seguro, y sería la alternativa ideal en casos de multirresistencia o difícil acceso a pruebas de susceptibilidad antibiótica. MÉD.UIS.2022;35(1): 31-42.

Abstract Helicobacter pylori infection is associated with gastroduodenal diseases such as chronic gastritis, peptic ulcer, and gastric adenocarcinoma. Nowadays, there are different therapeutic regimens, however, the indiscriminate use of antibiotics generated resistance in this agent, reason to study alternatives and reevaluate the criteria that determines the selection of a specific regimen. The aim of this review was to describe the general principles of treatment according to reference guidelines and recommendations of independent authors, and to present the use of rifabutin as a therapeutic alternative. The bibliographic search was performed using the terms "Helicobacter pylori" AND "rifabutin" in the databases PubMed, SciELO and the search engine Google Scholar®. Current evidence suggests that the use of rifabutin as rescue therapy is appropriate and safe, and would be an ideal alternative in cases of multidrug resistance or difficult access to antibiotic susceptibility tests. MÉD.UIS.2022;35(1): 31-42.

Humans , Helicobacter pylori , Rifabutin , Peptic Ulcer , Stomach Neoplasms , Gastritis
Rev. Eugenio Espejo ; 16(1): 18-28, 20220111.
Article in Spanish | LILACS | ID: biblio-1352923


Helicobacter pylori es un microrganismo que se considera que afecta al 50% de la población. Se realizó un estudio con diseño no experimental, correlacional y transversal, con el objetivo de determinar la asociación de los resultados de pruebas diagnósticas de infección por H. pylori a través de biopsia obtenida por endoscopía superior y prueba de antígeno de la superficie en mues-tras de heces en 100 pacientes atendidos en el Servicio de Gastroenterología del Centro Clínico Quirúrgico Ambulatorio (Hospital del Día) Efrén Jurado López del Instituto Ecuatoriano de Seguridad Social (IESS), en la ciudad de Guayaquil, Ecuador, durante 2019. La media de la edad en la muestra de estudio fue 37,5 años, con un predominio del género femenino (78%). El 65% de las pruebas de antígeno para la detección de H. pylori en heces resultaron negativas. Los repor-tes de las pruebas de antígeno en heces e histopatología permitieron apreciar diferencias entre estos, pero con predominio de las coincidencias en los diagnósticos positivos. Existió una asocia-ción estadísticamente significativa entre las lesiones inflamatorias de la mucosa gástrica producto de la gastritis crónica atrófica y la infección por H. pylori. Los resultados de las dos pruebas diag-nósticas tuvieron una correlación lineal positiva y débil con significación estadística.

Helicobacter pylori is a microorganism that affects 50% of the population worldwide. A study with a non-experimental, correlational, and cross-sectional design was carried out in order to determine the association of the results of diagnostic tests for H. pylori infection through biopsy obtained by upper endoscopy and surface antigen test in samples of feces in 100 patients. These ones were treated at the Gastroenterology Service of the Ambulatory Surgical Clinic Center (Hospital del Día) Efrén Jurado López of the Ecuadorian Institute of Social Security (IESS), in the city of Guayaquil, Ecuador, during 2019. The mean age in the study sample was 37.5 years old, with a predominance of the female gender (78%). 65% of stool antigen tests for H. pyloriwere negative. The reports of the stool antigen test and histopathology allowed to appreciate differences between them, but with a predominance of the coincidences in the positive diagno-ses. There was a statistically significant association between the inflammatory lesions of the gastric mucosa because of chronic atrophic gastritis and the infection by H. pylori. The results of the two diagnostic tests had a positive and weak linear correlation with statistical significance

Humans , Male , Female , Adult , Helicobacter pylori , Gastric Mucosa , Gastritis, Atrophic , Diagnostic Tests, Routine , Gastritis , Infections
São Paulo; s.n; 2022. 57 p. tab, ilus.
Thesis in Portuguese | LILACS, Inca | ID: biblio-1414261


Introdução: A atrofia gástrica (AG) e metaplasia intestinal (MI) são condições préneoplásicas no desenvolvimento de câncer gástrico, onde a avaliação endoscópica e histopatológica baseia-se no sistema atualizado de Sydney que inclui uma biópsia da incisura angular (IA) na sua avaliação, assim como os sistemas de estadiamento de risco de câncer gástrico Operative Link on Gastritis Assessment (OLGA) e o Operative Link on Gastritis Assessment using Intestinal Metaplasia (OLGIM). Objetivo: Comparar as classificações OLGA e OLGIM com e sem a biópsia da IA. Além disso, determinar a prevalência de Helicobacter pylori (HP) e das alterações pré-neoplásicas (AG, MI e displasia) por região biopsiada, e ainda identificar os achados exclusivos da IA, além de identificar potenciais fatores de risco para câncer gástrico associados às alterações pré-neoplásicas. Materiais e Métodos: Estudo observacional, retrospectivo e prospectivo, descritivo, unicêntrico com 350 pacientes sem diagnóstico de neoplasia gástrica, que realizaram endoscopia digestiva alta com biópsias na Gastroclínica Itajaí, no período de novembro de 2017 até outubro de 2018 (retrospectivo) e de março de 2020 a maio de 2022. A classificação histopatológica de gastrite obedeceu ao sistema Sydney atualizado, e a avaliação do risco de câncer gástrico aos sistemas OLGA e OLGIM. A metodologia aplicada avaliou os escores dos sistemas OLGA e OLGIM com e sem a avaliação da biópsia da IA. A análise estatística foi realizada utilizando medidas descritivas (frequências, porcentagens, média, desvio padrão, intervalo de confiança de 95%). A comparação entre os ranks foi feita pelo teste de Kruskal-Wallis ou Wilcoxon. Para analisar a relação entre as frequências foi utilizado o teste exato de Fisher bilateral. O score de Wilson com correção de continuidade foi aplicado ao intervalo de confiança. Resultados: A idade mediana foi de 54,7 anos, sendo 52,5% pacientes do gênero feminino e 47,5% do gênero masculino. A comparação entre o protocolo de biópsias empregado (corpo + antro [CA] vs corpo + antro + incisura [CAI]) e os estágios OLGA e OLGIM apresentou uma diminuição significativa em ambos os sistemas de estadiamento quando aplicado o protocolo de biópsia restrito ao corpo e antro (OLGA CAI vs CA; p 0,008 / OLGIM CAI vs CA; p 0,002). A prevalência das lesões pré-malignas (AG, MI e displasia) da mucosa gástrica foi de (33,4%, 34% e 1,1%, respectivamente) na amostra total. A região do antro foi o sítio que apresentou significativamente maior número de alterações (p≤0,0001), exceto para a positividade da infecção por HP, a qual esteve presente em 24,8% dos pacientes. Não foi possível fazer correlação entre os fatores de risco para desenvolvimento do câncer gástrico com os achados histológicos devido à baixa prevalência dos mesmos e a casuística ter resultado em uma amostra bastante limitada. Conclusão: A biópsia da incisura angular é importante porque aumentou o número de casos em estágios mais avançados de atrofia e metaplasia intestinal. O estudo apresentou limitações, onde a principal delas foi a amostra relativamente pequena e composta por indivíduos saudáveis apesar de idosos na sua maior parte

Introduction: Gastric atrophy (GA) and intestinal metaplasia (IM) are pre-neoplastic conditions in the development of gastric cancer, where endoscopic and histopathological evaluation is based on the updated Sydney system that includes a biopsy of the incisura angularis (IA), as well as the Operative Link on Gastritis Assessment (OLGA) and Operative Link on Gastritis Assessment using Intestinal Metaplasia (OLGIM) gastric cancer risk staging systems. Objective: To compare the OLGA and OLGIM classifications with and without IA biopsy. In addition, to determine the prevalence of Helicobacter pylori (HP) and preneoplastic changes (AG and IM) by biopsied region, and to identify the exclusive findings of IA. Also, to identify potential risk factors for gastric cancer associated with pre-neoplastic changes. Materials and Methods: Observational, retrospective and prospective, descriptive, unicentric study with 350 patients without a diagnosis of gastric cancer, who underwent upper digestive endoscopy with biopsies at Gastroclínica Itajaí, from November 2017 to October 2018 (retrospective) and from March 2020 to May 2022. The histopathological classification of gastritis followed the updated Sydney system, and the gastric cancer risk assessment followed the OLGA and OLGIM systems. The methodology applied evaluated the scores of the OLGA and OLGIM systems with and without the assessment of the IA biopsy. Statistical analysis was performed using descriptive measures (frequencies, percentages, mean, standard deviation, 95% confidence interval). Ranks were compared using the Kruskal-Wallis or Wilcoxon tests. To analyze the relationship between the frequencies, the bilateral Fisher's exact test was used. Wilson's score with continuity correction was applied to the confidence interval. Results: The median age was 54,7 years, with 52,5% female patients and 47,4% male patients. The comparison between the used biopsies protocol (corpus + antrum [CA] vs corpus + antrum + incisura angularis [CAI]) and the OLGA and OLGIM stages showed a significant decrease in both staging systems when the biopsy protocol restricted to the corpus and antrum was applied (OLGA CAI vs CA; p 0,008 / OLGIM CAI vs CA; p 0,002). The prevalence of pre-malignant lesions (GA, IM and dysplasia) of the gastric mucosa was (33,4%, 34% and 1,1%, respectively) in the total sample. The antrum region was the site that presented a significantly higher number of alterations (p≤0,0001), except for the positivity of HP infection, which was present in 24,8% of the patients. It was not possible to make a correlation between the risk factors for the development of gastric cancer and the histological findings because the casuistry resulted in a very limited sample with low prevalence of risk factors. Conclusion: Incisura angularis biopsy is important because it increased the number of cases in more advanced stages of intestinal metaplasia and atrophy. The study had limitations, the main one being the relatively small sample composed of healthy individuals, although mostly elderly

Stomach Neoplasms , Biopsy , Gastritis , Atrophy , Helicobacter pylori , Risk Assessment , Metaplasia
Bol. malariol. salud ambient ; 62(3): 472-478, 2022. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1396002


Determinar la relación entre la infección por Helicobacter pylori y hemorragia digestiva alta (HDA) y su frecuencia fue el objetivo de la investigación, siendo ésta de tipo descriptivo correlacional con 50 pacientes con hemorragia digestiva, que acudieron al Servicio de Gastroenterología del Hospital Nacional Arzobispo Loayza de Perú, durante los meses de julio a octubre del 2021. Se elaboró un instrumento de recolección de información para las variables; edad, género, procedencia, ocupación y grado de instrucción. Se determinó la presencia de H. pylori a través de la realización de biopsia gástrica (identificación histopatológica). Para determinar la correspondencia entre las variables de la investigación, se utilizó la correlación de Pearson. Al evaluar el riesgo entre las patologías gastrointestinales y sufrir HDA se encontró para enfermedad ulcero péptica un (OR=7,1 IC: 1,394-35,987), gastritis (OR=13,7 IC: 1,068-174,81), y litiasis vesicular (OR=1,2 IC: 1,056-1,352). Dentro de los hábitos de los pacientes con HDA, 1 de cada 4 reportó consumir bebidas alcohólicas, 1 de cada 8 manifestó tabaquismo, y 1 de 2 reportó hábito cafeico. Se encontró una correlación positiva entre las variables hemorragia digestiva alta e infección por H. Pylori, ya que el coeficiente reportado es igual a 0,685. Se determinó una correlación positiva entre las variables hemorragia digestiva alta e infección por H. pylori en pacientes valorados por el servicio de gastroenterología del hospital. La infección por H. Pylori es de prevalencia elevada en la población general, sin embargo, el estudio muestra que no se manifiesta frecuentemente con sintomatología sangrante alta(AU)

Determining the relationship between infection by Helicobacter pylori and upper gastrointestinal bleeding (UGH) and its frequency was the objective of the investigation, this being descriptive correlational with 50 patients with gastrointestinal bleeding, who attended the Gastroenterology Service of the Arzobispo Loayza National Hospital. from Peru, during the months of July to October 2021. An information recollection instrument was developed for the variables; age, gender, origin, occupation and level of education. The presence of H. pylori was determined by performing a gastric biopsy (histopathological identification). To determine the correspondence between the research variables, the Pearson correlation was used. When evaluating the risk between gastrointestinal pathologies and suffering from UGIB, peptic ulcer disease (OR=7.1 CI: 1.394-35.987), gastritis (OR=13.7 CI: 1.068-174.81), and gallstones were found. (OR=1.2 CI:1.056-1.352). Among the habits of patients with HDA, 1 out of 4 reported consuming alcoholic beverages, 1 out of 8 reported smoking, and 1 out of 2 reported a coffee habit. A positive correlation was found between the variables upper gastrointestinal bleeding and H. Pylori infection, since the reported coefficient is equal to 0.685. A positive correlation was found between the variables upper gastrointestinal bleeding and H. pylori infection in patients assessed by the gastroenterology service of the hospital. H. Pylori infection is highly prevalent in the general population, however, the study shows that it does not manifest frequently with high bleeding symptoms(AU)

Humans , Male , Female , Adult , Middle Aged , Aged , Helicobacter pylori , Gastrointestinal Hemorrhage , Infections , Biopsy , Prevalence , Gastritis , Gastroenterology
Afro-Egypt. j. infect. enem. dis ; 10(2): 141-150, 2022. figures, tables
Article in English | AIM | ID: biblio-1426330


Abdominal ultrasonography is effective in the visualization of gastric wall layers and measuring its thickness. The study aimed to assess gastric antral wall thickness in patients with H. pylori gastritis by abdominal ultrasonography and to study its predictive value in detecting H. pylori gastritis.

Humans , Helicobacter pylori , Gastritis , Case-Control Studies , Ultrasonography , Needs Assessment
Malaysian Journal of Microbiology ; : 261-270, 2022.
Article in English | WPRIM | ID: wpr-979266


Aims@#Helicobacter pylori is a gastrointestinal bacterium that causes peptic ulcers and stomach cancer in nearly half of the world’s population. Many virulence factors influence the outcome of H. pylori related disorders. The purpose of this study was to see if there was a relationship between H. pylori virulence factors and histological and endoscopic findings in stomach biopsy specimens from Sudanese gastritis patients.@*Methodology and results@#In the period between March 2018 and January 2020, a total of 290 gastric biopsies were taken from patients in Khartoum State hospitals. Histopathology and polymerase chain reaction (PCR) assays were performed on all specimens. Histological investigation revealed H. pylori in 103/290 (35.5%) samples, while PCR revealed H. pylori 16S rRNA positivity in 88/290 (30.3%) samples. Eighty-eight positive PCR specimens were subjected to PCR for genotypic detection of cagA, cagE, vacA, dupA and iceA1 genes. All of strains were vacA positive 100% (88/88) followed by dupA 50.0% (44/88), cagA 40.9% (36/88), cagE gene 38.6% (34/88) and iceA1 gene was detected in only 15.9% (14/88). The vacA s1/m1 68.2% (60/88) was the most prevalent vacA subtype.@*Conclusion, significance and impact of study@#Helicobacter pylori virulence genes were widespread and diversified in Sudanese gastritis patients. Helicobacter pylori cagA and iceA1 were significantly in association with gastric mucosa inflammation degree, whereas the dupA gene was found to be associated with the clinical outcomes.

Helicobacter pylori , Gastritis
Chinese Journal of Oncology ; (12): 531-539, 2022.
Article in Chinese | WPRIM | ID: wpr-940919


Objective: To analyze and compare the distribution of the high-risk population of upper gastrointestinal (UGI) cancer and the factors influencing the compliance rate of endoscopic screening in urban China and rural China. Methods: From 2015 to 2017, an epidemiological survey was conducted on residents aged 40-69 in two rural areas (Luoshan county of Henan province, Sheyang county of Jiangsu province) and two urban areas (Changsha city of Hunan province, Harbin city of Heilongjiang province). As a result, high-risk individuals were recommended for endoscopic screening. Chi-square χ(2) test was used to compare the high-risk rate of UGI cancer between urban and rural residents. In addition, the multivariate logistic regression model was used to analyze the factors influencing the compliance rate of endoscopic screening. Results: A total of 48, 310 residents aged 40-69 were enrolled in this study, including 22 870 (47.34%) residents from rural areas and 25 440 (52.66%) residents from urban areas. A total of 23 532 individuals were assessed with a high risk of UGI cancer, with an overall risk rate of 48.71%. A higher proportion of participants with high risk was observed in rural China (56.17%, 12 845/22 870) than in urban China (42.01%, 10 687/25 440). A total of 10 971 high-risk individuals with UGI cancer participated in endoscopic screening, with an overall compliance rate of 46.62% (10 971/23 532), 45.15% (5 799/12 845) in rural China, and 48.40% (5 172/10 687) in urban China. In rural population, the compliance rate of endoscopic screening was higher in those of females, aged 50-69 years, primary school education or above, high income, a family history of UGI cancer, history of gastric and duodenal ulcer, history of reflux esophagitis, and history of superficial gastritis, but lower in smokers (P<0.05). Among the urban population, the compliance rate of endoscopic screening was higher in those aged 40-49 years, uneducated, low income, family history of UGI cancer, history of reflux esophagitis, history of superficial gastritis, but lower in smokers (P<0.05). Conclusions: The proportion of participants with high risk of UGI cancer in rural areas is higher than that of urban areas. The compliance rates of endoscopic screening in urban and rural areas are low, and influencing factors of endoscopic screening exhibit some differences in rural China and urban China.

Female , Humans , China/epidemiology , Early Detection of Cancer , Esophagitis, Peptic , Gastritis , Gastrointestinal Neoplasms/epidemiology , Rural Population , Urban Population
São Paulo med. j ; 139(6): 564-569, Nov.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1352283


ABSTRACT BACKGROUND: Gastritis consists of inflammation of the gastric mucosa and is one of the main causes of dyspeptic symptoms in children. OBJECTIVE: To investigate the presence of inflammation by evaluating fecal calprotectin (FC) in children diagnosed with chronic gastritis. DESIGN AND SETTING: Descriptive study in Pediatric Gastroenterology Department of Ondokuz Mayis University Hospital in Turkey. METHODS: Between January 2016 and July 2018, FC levels were compared retrospectively in children with chronic gastritis (histopathology-based diagnosis), patients with inflammatory bowel disease (IBD) and healthy children. RESULTS: A total of 67 chronic gastritis patients (61.2% girls) with a mean age of 13.09 ± 3.5 years were evaluated. The mean FC levels were 153.4 μg/g in the chronic gastritis group, 589.7 μg/g in the IBD group and 43.8 μg/g in the healthy group. These levels were higher in chronic gastritis patients than in healthy individuals (P = 0.001) and higher in IBD patients than in the other two groups (P < 0.001). The FC level in the patients with chronic active gastritis (156.3 μg/g) was higher than in those with chronic inactive gastritis (150.95 μg/g) (P = 0.011). Among the patients with chronic active gastritis, the FC level was significantly higher in Helicobacter pylori-positive individuals than in negative individuals (P = 0.031). CONCLUSION: We confirmed the association between increased FC and chronic gastritis. Elevated FC levels may be seen in patients with chronic active gastritis. In order to be able to use FC as a screening tool for chronic gastritis, further studies in a larger study group are needed.

Humans , Male , Female , Child , Adolescent , Inflammatory Bowel Diseases , Gastritis/diagnosis , Biomarkers , Retrospective Studies , Leukocyte L1 Antigen Complex , Feces
Más Vita ; 3(4): 33-40, dic. 2021. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1355015


La gastritis es una enfermedad con una alta morbilidad a nivel mundial, el principal factor de riesgo es la infección por Helicobacter pylori. Objetivo: Describir las características clínicas, histopatológica y endoscópicas en una población con gastritis crónica. Material y métodos: Se realizó un estudio observacional de tipo descriptivo, retrospectivo, se incluyeron 49 pacientes que acudieron a la consulta externa del área de gastroenterología, de 18 a 65 años, a quienes se realizó el estudio histopatológico y endoscópico en el Servicio de Gastroenterología en el Hospital General Quevedo, de Los Ríos-Ecuador, durante septiembre 2017 ­ septiembre 2018. Resultados: Se observó predominio del género masculino (65%); en mayores de 40 años (55%), la epigastralgía y la sensación de acidez estomacal, 39% y 35% respectivamente, fueron los síntomas más frecuentes, La positividad para Helicobacter pylori, alcanzó el 86%, y la lesión no erosiva un 73%, existió mayor presencia de la forma no atrófica (84%) sobre la atrófica. Conclusiones: La gastritis crónica predominó en el grupo etario mayor a 40 años y de género masculino, siendo los factores de riesgo de mayor prevalencia la infección por Helicobacter pylori y los asociados al consumo de antiinflamatorios no esteroideos, mala alimentación, alcohol y tabaco, los síntomas como epigastralgía y la sensación de acidez estomacal fueron los más frecuentes. El hallazgo endoscópico fue mayor para las formas no erosivas, y de acuerdo a la histopatología la gastritis no atrófica antral moderada fue la más frecuente(AU)

Gastritis is a disease with high morbidity worldwide, the main risk factor is Helicobacter pylori infection. Objective: To describe the clinical, histopathological and endoscopic characteristics in a population with chronic gastritis. Material and methods: An observational, descriptive, retrospective study was carried out, including 49 patients who attended the outpatient consultation of the gastroenterology area, aged 18 to 65 years, who underwent a histopathological and endoscopic study in the Gastroenterology Service at the Quevedo General Hospital, Los Ríos-Ecuador, during September 2017 - September 2018. Results: A predominance of the male gender was observed (65%); In people over 40 years of age (55%), epigastralgia and the sensation of heartburn, 39% and 35% spectively, were the most frequent symptoms, the positivity for Helicobacter pylori, reached 86%, and the non-erosive lesion 73 %, there was a greater presence of the non-atrophic form (84%) over the atrophic one. Conclusions: Chronic gastritis predominated in the age group over 40 years of age and male, the most prevalent risk factors being Helicobacter pylori infection and those associated with the consumption of non-steroidal anti-inflammatory drugs, poor diet, alcohol and tobacco. symptoms such as epigastric pain and the sensation of heartburn were the most frequent. The endoscopic finding was greater for non-erosive forms, and according to histopathology, moderate antral non-atrophic gastritis was the most frequent(AU)

Humans , Male , Female , Adult , Middle Aged , Anti-Inflammatory Agents, Non-Steroidal , Helicobacter pylori/drug effects , Dyspepsia/etiology , Gastric Mucosa/pathology , Gastritis/physiopathology , Peptic Ulcer , Signs and Symptoms , Biopsy , Pharmaceutical Preparations , Endoscopy, Gastrointestinal , Acidity , Gastroenterology
Arq. gastroenterol ; 58(3): 353-358, July-Sept. 2021. tab
Article in English | LILACS | ID: biblio-1345299


ABSTRACT BACKGROUND: The Prex2 protein is a member of the Rac family proteins that belongs to small G proteins with a critical role in cell migration, cell proliferation, and apoptosis through its effects on PI3K cell signaling pathway and phosphatase activity of PTEN protein. The effect of PREX2 gene expression has been shown in some cancer cells. A survey of PREX2 gene expression in gastric antral epithelial cells of gastric cancer patients with Helicobacter pylori various genotypes infection can conduct to better understanding H. pylori infection's carcinogenesis. METHODS: In a case-control study, PREX2 gene expression was evaluated in gastric antral biopsy samples on four groups of patients referred to Sanandaj hospitals, including gastritis with (n=23) and without (n=27) H. pylori infection and gastric cancer with (n=21) and without (n=32) H. pylori infection. Each gastric biopsy sample's total RNA was extracted and cDNA synthesized by using Kits (Takara Company). The PREX2 gene expression was measured using the relative quantitative real-time RT-PCR method and ΔΔCt formula. RESULTS: The PREX2 gene expression increased in gastric antral biopsy samples of gastritis and gastric cancer patients with H. pylori infection (case groups) than patients without H. pylori infection (control groups) 2.38 and 2.27 times, respectively. The patients with H. pylori vacA s1m1 and sabB genotypes infection showed a significant increase of PREX2 gene expression in gastric cancer antral epithelial cells. CONCLUSION: H. pylori vacA s1m1 and sabB genotypes have the positive correlations with PREX2 gene expression in gastric antral epithelial cells of gastritis and gastric cancer patients.

RESUMO CONTEXTO: A proteína Prex2 é membro das proteínas da família Rac que pertencem a pequenas proteínas G com um papel crítico na migração celular, na proliferação celular e na apoptose através de seus efeitos na via de sinalização celular PI3K e atividade fosfatase da proteína PTEN. O efeito da expressão genética PREX2 tem sido mostrada em algumas células cancerosas. Um levantamento da expressão genética PREX2 em células epiteliais antrais gástricas de pacientes infectados com vários genótipos de Helicobacter pylori pode conduzir a um melhor entendimento da carcinogênese da infecção por H. pylori. MÉTODOS: Em estudo de caso-controle, a expressão genética PREX2 foi avaliada em amostras de biópsia antral gástrica em quatro grupos de pacientes encaminhados aos hospitais de Sanandaj, incluindo gastrite com (n=23) e sem (n=27) infecção por H. pylori e de câncer gástrico com (n=21) e sem (n=32) infecção por H. pylori. O RNA total de cada amostra de biópsia gástrica foi extraído e cDNA sintetizado por meio de kits (Takara Company). A expressão genética PREX2 foi medida utilizando-se o método RT-PCR em tempo real quantitativo relativo e a fórmula ΔΔCt. RESULTADOS: A expressão genética PREX2 aumentou em amostras de biópsia antral gástrica de pacientes com gastrite e câncer gástrico com infecção por H. pylori (grupos de casos) em relação aos sem infecção por H. pylori (grupos de controle) 2,38 e 2,27 vezes, respectivamente. Os pacientes com infecção por genótipos H. pylori vacA s1m1 e sabB apresentaram um aumento significativo da expressão genética PREX2 em células epiteliais antrais de câncer gástrico. CONCLUSÃO: Os genótipos H. pylori vacA s1m1 e sabB têm correlações positivas com a expressão genética PREX2 em células epiteliais antrais gástricas de pacientes com câncer gástrico e gastrites.

Humans , Helicobacter Infections , Guanine Nucleotide Exchange Factors/genetics , Gastritis/genetics , Gastritis/microbiology , Case-Control Studies , Helicobacter pylori , Epithelial Cells/metabolism , Epithelial Cells/microbiology , Gastric Mucosa
Medicina (Ribeirão Preto) ; 54(1)jul, 2021. fig.
Article in Portuguese | LILACS | ID: biblio-1353724


RESUMO: Introdução: A infecção pelo Helicobacter pylori (HP) e fatores ambientais são importantes fatores de risco para gastrite. Estudos apontam correlação entre o sistema ABO e doenças gastrointestinais. Objetivos: caracterizar o perfil sociodemográfico de portadores de gastrite e HP e sua correlação com o sistema do grupo sanguíneo ABO. Materiais e métodos: Estudo prospectivo e descritivo, realizado em Aracaju, Sergipe, Brasil, de abril/2018 a maio/2019. Amostra constituída por 133 pacientes que realizaram endoscopia digestiva alta, análise histopatológi-ca e tipagem sanguínea. Foram diagnosticados com gastrite 93 pacientes. Utilizou-se questionário sociodemográ-fico e clínico. Os dados foram analisados pelo RCore Team 2019 e submetidos a análises descritivas e inferenciais. Nível de significância 5%. Resultados: Idade média 53,7 anos (DP 17,4) sendo 48 (51,6%) do sexo masculino (p=0,018), 56 (65,9%) pardos, 45 (52,9%) casados e 33 (35,5%) tinham empregos fixos. Dos portadores de gastrite, 59 (63,4%) eram do tipo sanguíneo O. Dentre os tipos de gastrite, 31(33,4%) eram enantematosa leve e 16 (51,6%) desses eram do tipo O. Houve prevalência do tipo O em todos os graus de atividade inflamatória. Foi detectado H. pylori em 29 (31,2%) pacientes, sendo o fenótipo O mais prevalente nos graus moderado e severo da infecção. Conclusão: Os homens foram mais acometidos de gastrite, independente do tipo segundo a classificação de Sydney. O fenótipo sanguíneo O foi mais prevalente nos portadores de gastrite, naqueles que apresentaram atividade inflamatória à histologia e em portadores de H. pylori grau moderado e severo. (AU)

ABSTRACT: Introduction: Helicobacter pylori (HP) infection and environmental factors are important risk factors for gastritis. Studies show a correlation between the ABO system and gastrointestinal diseases. Aims: To characterize the sociodemographic profile of patients with gastritis and HP and its correlation with the ABO blood group system. Materials and methods: Prospective and descriptive study, carried out in Aracaju, Sergipe, Brazil, from April / 2018 to May / 2019. Samples were collected from 133 patients who underwent upper digestive endoscopy, histo-pathological analysis, and blood typing. Out of which, 93 patients were diagnosed with gastritis. A sociodemographic and clinical questionnaire was also used. Data analyzed by RCore Team 2019 and submitted to descriptive and inferential analyzes. Results: Average age 53.7 (SD 17.4) with 48 (51.6%) being male (p = 0.018), 56 (65.9%) brown, 45 (52.9%) married and 33 (35.5%) pursuing permanent jobs. Fifty-nine patients (63.4%) out of those with gastritis were blood type O. Among the types of gastritis, 31 (33.4%) were mild enanthematous and 16 (51.6%) of these were type O. There was a prevalence type O in all degrees of inflammatory activity. H. pylori were detected in 29 (31.2%) patients; the most prevalent phenotype being the moderate and severe degrees of infection. Conclusion: Men were mostly affected by gastritis, regardless of the type according to the Sydney classification. The blood phenotype O was more prevalent in patients with gastritis, in those who had inflammatory activity at histology and in patients with moderate, and severe H.pylori. (AU)

Humans , Male , Female , Blood Grouping and Crossmatching , Helicobacter pylori , Endoscopy , Gastritis