Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 1.588
Filter
2.
Más Vita ; 3(4): 33-40, dic. 2021. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1355015

ABSTRACT

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)


Subject(s)
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
3.
Arq. gastroenterol ; 58(3): 353-358, July-Sept. 2021. tab
Article in English | LILACS | ID: biblio-1345299

ABSTRACT

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.


Subject(s)
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
4.
Medicina (Ribeirão Preto) ; 54(1)jul, 2021. fig.
Article in Portuguese | LILACS | ID: biblio-1353724

ABSTRACT

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)


Subject(s)
Humans , Male , Female , Blood Grouping and Crossmatching , Helicobacter pylori , Endoscopy , Gastritis
5.
Rev. Rede cuid. saúde ; 15(1): [1-11], 15/07/2021.
Article in Portuguese | LILACS | ID: biblio-1282324

ABSTRACT

Objetivou-se caracterizar as EDA realizadas na Comunidade de Saúde de Mossoró, RN, no período de 2008 a 2013, definindo a taxa de exames normais e a prevalência dos principais achados sugestivos de patologias digestivas. Trata-se de um estudo transversal e retrospectivo, no qual se analisou 10311 laudos de EDA. As análises estatísticas foram realizadas pelo SPSS (Statistical Package for the Social Sciences, versão 20.0), com nível de confiança95% e um p < 0,05, utilizando-se testes Qui-quadrado. Pelos dados levantados, constatamos que a EDA é um exame prático e seguro, com raríssimas complicações, sendo a agitação e a presença de alimento no estômago as limitações mais comuns. Na análise descritiva geral observou-se que a maioria dos exames foi realizada no gênero feminino, formando mais de 70% da amostra total. A faixa etária predominante, independente do gênero, foi 41 a 60 anos. As patologias frequentes no segmento esofágico foram as Esofagites. No segmento gástrico, a maior frequência de achados foram as Gastrites, que são mais frequentes com o avançar da idade. Na Transição Gastroduodenal, as úlceras de Canal Pilórico são os achados mais descritos, mas observamos também modestos achados de duodenites. No duodeno, os principais achados foram úlceras duodenais, seguidas pelas duodenites e sinais de atrofia. Portanto, as EDA são mais realizadas no gênero feminino, mas apresentam maior percentual de exames normais, sendo a maior frequência de achados encontrada no gênero masculino. Assim, após analisar as 10.311 EDA, é possível prever os achados mais comuns encontrados a EDA.


This study aimed to characterize the EDA held in Mossoro Health Community, RN, from 2008 to 2013, setting the rate of normal examinations and the prevalence of the main findings suggestive of digestive pathologies. It is a cross-sectional retrospective study, which analyzed 10,311 reports of EDA. Statistical analyzes were performed using SPSS (Statistical Package for Social Sciences, version 20.0), with a confidence level 95% and p <0.05, using chi-square tests. Raised by the data, we found that EDA is a practical and safe exam, with very few complications, agitation and presence of food in the stomach the most common limitations. In general descriptive analysis it was observed that most of the exams was held in females, forming more than 70% of the total sample. The predominant age group, regardless of gender, was 41-60 years. The frequent pathologies in esophageal segment were Esophagitis. Gastric segment, the highest frequency of findings were Gastritis, which are more common with advancing age. Gastroduodenal in Transition, the Channel Pyloric ulcers are the most described findings, but also observed modest findings of duodenitis. In the duodenum, the main findings were duodenal ulcers, followed by duodenitis and signs of atrophy. Therefore, the EDA are more performed in females, but have a higher percentage of normal results, with the highest frequency of findings found in males. So after analyzing 10,311 EDA, it is possible to predict the most common findings EDA.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Diagnosis , Duodenitis , Endoscopy , Esophagitis , Gastritis
6.
Arq. gastroenterol ; 58(1): 114-119, Jan.-Mar. 2021. tab, graf
Article in English | LILACS | ID: biblio-1248992

ABSTRACT

ABSTRACT Helicobacter pylori is the main etiological agent of all malignant tumors caused by an infectious disease. It is a major, at times dominant, factor in the pathogenesis of a large spectrum of diseases such as acute and chronic gastritis, gastric and duodenal ulcers, gastric carcinoma, and lymphoma. Epidemiological and experimental studies suggest that H. pylori chronic infection may be related to different extragastric diseases, including colorectal neoplasms. This concise review aims to explore the association of H. pylori infection with colorectal cancer and adenoma, including the recent epidemiological findings, the diagnostic methods employed to detect H. pylori and virulent factors, and the potentially involved mechanisms. Furthermore, is attempted to establish the current data integration for causal inference using the Bradford-Hill causality criteria. The weak, although global, strength of the epidemiological positive association between H. pylori infection and colonic neoplasms associated to new mechanisms postulated to explain this interaction, including intestinal dysbiosis, should stimulate future studies. Prospective confirmatory studies to establish the role of H. pylori eradication in the process of carcinogenic transformation of the colonic epithelium may define its eventual role in the treatment and prevention of colonic neoplasms.


RESUMO Helicobacter pylori é o principal agente etiológico dos tumores malignos causados por doenças infecciosas. Constitui fator importante, às vezes dominante, na patogênese de um amplo espectro de doenças como gastrite aguda e crônica, úlceras gástricas e duodenais, carcinoma gástrico e linfoma. Estudos epidemiológicos e experimentais sugerem que a infecção crônica por H. pylori pode estar relacionada a diferentes doenças extragástricas, incluindo neoplasias colorretais. Esta concisa revisão tem como objetivo explorar a associação da infecção por H. pylori com câncer colorretal e adenoma, incluindo os recentes achados epidemiológicos, os métodos de diagnóstico empregados para detectar H. pylori e seus fatores de virulência com os mecanismos potencialmente envolvidos nesta relação. Além disso, procura-se estabelecer a integração dos dados atuais na busca de inferência causal com o emprego dos critérios de causalidade de Bradford-Hill. A associação epidemiológica positiva entre infecção por H. pylori e neoplasias do cólon embora classificada como fraca - porém global - do ponto de vista epidemiológico, quando associada a mecanismos recentemente postulados para explicar essa interação, incluindo disbiose intestinal, deverá estimular a realização de investigações futuras. Estudos prospectivos confirmatórios para estabelecer o papel da erradicação do H. pylori no processo de transformação carcinogênica do epitélio do cólon são aguardados para definir seu eventual papel no tratamento e prevenção de neoplasias do cólon.


Subject(s)
Humans , Stomach Neoplasms/etiology , Stomach Neoplasms/epidemiology , Colorectal Neoplasms/etiology , Colorectal Neoplasms/epidemiology , Helicobacter pylori , Helicobacter Infections/complications , Helicobacter Infections/epidemiology , Gastritis , Prospective Studies
7.
Arq. gastroenterol ; 58(1): 39-47, Jan.-Mar. 2021. tab, graf
Article in English | LILACS | ID: biblio-1248990

ABSTRACT

ABSTRACT BACKGROUND: H. pylori chronic atrophic gastritis is a premalignant lesion, and its staging, according to OLGA and OLGIM systems aims to identify patients at increased risk of developing gastric cancer and optimize their follow-up. GastroPanel®, serum biomarkers panel including pepsinogen I (PGI), pepsinogen II (PGII), Gastrin 17 (G17) and anti- H. pylori antibodies is a noninvasive test for adenocarcinoma risk assessment in chronic H. pylori gastritis patients. OBJECTIVE: Prospective study to evaluate the concordance between OLGA and OLGIM grading systems, as well as to evaluate GastroPanel´s performance in patients with premalignant lesions secondary to H. pylori chronic gastritis in Brazil. METHODS: Patients with H. pylori chronic gastritis with premalignant lesions confirmed by histology were recruited from the gastrointestinal clinic of a University Hospital. All participants underwent endoscopic examination with biopsies which were reported according to updated Sydney system and premalignant lesions grading systems (OLGA and OLGIM). Blood samples were collected for biomarkers serological analysis (GastroPanel®, Biohit, Helsinki, Finland). The cut off values used to define high risk patients were those recommended by the manufacturer: PGI ≤30 µm/L and PGI/PGII ≤3. RESULTS: 41 patients were recruited: 28 women, 13 men, mean age 67.3 (47-89, SD: 9.6) years. By OLGA system, were obtained: OLGA 0 (n=1), OLGA I (n=7), OLGA II (n=17), OLGA III (n=9), and OLGA IV (n=7). By OLGIM system, were obtained: OLGIM 0 (n=14), OLGIM I (n=5), OLGIM II (n=10), OLGIM III (n=10), and OLGIM IV (n=2). Regarding histological staging among patients staged as low risk (OLGA/OLGIM 0, I and II) and high risk (OLGA/OLGIM III and IV) for gastric cancer development, the concordance rate found between both classifications was 85.4%. Considering high risk patients, those patients thus included in at least one of the systems the final distribution of our sample considered 24 low-risk and 17 high-risk patients for the development of gastric cancer. To determine by GastroPanel® whether the patient would be at low or high risk of developing gastric cancer, PGI showed a sensitivity, specificity and accuracy of 0.47 (95%CI: 0.26-0.69), 0.67 (95%CI: 0.47-0.82), and 0.58 (95%CI: 0.43-0.72), respectively, while PGI/PGII showed sensitivity, specificity and accuracy of 0.06 (95%CI: 0.01-0.27), 0.83 (95%CI: 0.64-0.93) and 0.51 (95%CI: 0.36-0.66), respectively. CONCLUSION: The histological classifications OLGA and OLGIM presented a substantial concordance rate among themselves. Simultaneous use of both histological classification systems increased the identification's rate of high-risk patients. Biomarker analysis was not effective to distinguish low to high risk patients in the studied population. Further studies are needed to validate its use in clinical practice in Brazil.


RESUMO CONTEXTO: Gastrite atrófica crônica por H. pylori constitui lesão pré-maligna e seu estadiamento de acordo com os sistemas OLGA e OLGIM, visa identificar pacientes com maior risco de desenvolver câncer gástrico e otimizar seu acompanhamento. GastroPanel® é um teste não invasivo composto por painel de biomarcadores séricos incluindo pepsinogênio I (PGI), pepsinogênio II (PGII), gastrina 17 (G17) e anticorpos anti- H. pylori para avaliação de risco de adenocarcinoma gástrico em pacientes com gastrite crônica por H. pylori. OBJETIVO: Estudo prospectivo para avaliar a concordância entre os sistemas de classificação OLGA e OLGIM, bem como avaliar o desempenho do GastroPanel® em pacientes com lesões pré-malignas secundárias à gastrite crônica por H. pylori no Brasil. MÉTODOS: Pacientes com gastrite crônica por H. pylori portadores de lesões pré-malignas confirmadas por histologia (gastrite atrófica e metaplasia intestinal) foram recrutados no ambulatório de gastroenterologia de um hospital universitário. Todos os participantes foram submetidos a exame endoscópico com biópsias de antro e corpo gástricos analisadas de acordo com o Sistema Sydney atualizado e estadiadas pelos Sistemas OLGA e OLGIM de classificação das gastrites. Amostras de sangue foram coletadas para análise sorológica de biomarcadores (GastroPanel®, Biohit, Helsinki, Finlândia). Os valores de corte utilizados para definir pacientes de alto risco para desenvolvimento de câncer gástrico foram os recomendados pelo fabricante: PGI ≤30 µm e PGI/PGII ≤3. RESULTADOS: Foram recrutados 41 pacientes: 28 mulheres, 13 homens, idade média 67,3 (47-89, DP: 9,6) anos. Pelo sistema OLGA, foram obtidos: OLGA 0 (n=1), OLGA I (n=7), OLGA II (n=17), OLGA III (n=9) e OLGA IV (n=7). Pelo sistema OLGIM, foram obtidos: OLGIM 0 (n=14), OLGIM I (n=5), OLGIM II (n=10), OLGIM III (n=10) e OLGIM IV (n=2). Em relação ao estadiamento histológico entre os pacientes de baixo risco (OLGA/OLGIM 0, I e II) e alto risco (OLGA/OLGIM III e IV) para o desenvolvimento de câncer gástrico, a taxa de concordância encontrada entre as duas classificações foi de 85,4%, com valor kappa=0,678 (IC95%: 0,440-0,916). Considerando como pacientes de alto risco, aqueles assim estadiados em pelo menos um dos sistemas, a distribuição final de nossa amostra encontrou 24 pacientes de baixo risco e 17 de alto risco para o desenvolvimento de câncer gástrico. Na determinação pelo GastroPanel® para classificação do paciente como de baixo ou alto risco para desenvolvimento de câncer gástrico, PGI mostrou sensibilidade, especificidade e acurácia de 0,47 (IC95%: 0,26-0,69), 0,67 (IC95%: 0,47-0,82) e 0,58 (IC95%: 0,43-0,72), respectivamente, enquanto a razão PGI/PGII mostrou sensibilidade, especificidade e acurácia de 0,06 (IC95%: 0,01-0,27), 0,83 (IC95%: 0,64-0,93) e 0,51 (IC95%: 0,36-0,66), respectivamente. CONCLUSÃO: As classificações histológicas OLGA e OLGIM apresentaram taxa de concordância substancial entre si. O uso simultâneo de ambos os sistemas de classificação histológica aumentou a taxa de identificação de pacientes de alto risco para desenvolvimento de câncer gástrico. Os resultados do GastroPanel® não foram eficazes para distinguir pacientes de baixo e alto risco para desenvolvimento de câncer gástrico na população estudada. Mais estudos são necessários para validar seu uso na prática clínica no Brasil.


Subject(s)
Humans , Male , Female , Aged , Stomach Neoplasms , Helicobacter pylori , Helicobacter Infections , Gastritis , Brazil , Biomarkers , Prospective Studies , Risk Factors , Metaplasia
8.
Rev. colomb. gastroenterol ; 36(1): 87-92, ene.-mar. 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1251526

ABSTRACT

Resumen A través del presente reporte se describe un caso de gastritis enfisematosa, una rara condición clínica consistente en la invasión de la pared gástrica por microorganismos productores de gas. Puede resultar en una situación fatal debido a lo inespecífico de su clínica y a lo tórpido de su evolución. En este caso se describe a un paciente anciano de 77 años, con alta fragilidad, quien cursaba con un cuadro de gastritis enfisematosa que no respondió a manejo médico y requirió gastrectomía de urgencia. Adicionalmente, cursaba con un adenocarcinoma gástrico ulcerado infiltrante, que previamente no había sido diagnosticado, como probable factor condicionante y desencadenante.


Abstract This report describes a case of emphysematous gastritis, a rare clinical condition consisting of invasion of the gastric wall caused by gas-producing bacteria. It can lead to fatal outcomes due to the unspecific nature of the symptoms and its torpid course. The following is the case of a highly fragile 77-year-old male patient, who presented with symptoms of emphysematous gastritis that did not respond to medical treatment and required emergency gastrectomy. In addition, the patient had an infiltrating ulcerated gastric adenocarcinoma, which had not previously been diagnosed and was a probable conditioning and triggering factor.


Subject(s)
Humans , Male , Aged , Adenocarcinoma , Gastritis , Emergencies
9.
Rev. colomb. gastroenterol ; 36(1): 130-137, ene.-mar. 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1251534

ABSTRACT

Resumen Introducción: en el estudio de la baja talla de origen digestivo en niños no hay un patrón de paraclínicos preestablecido; sin embargo, la endoscopia de vías digestivas puede ser una herramienta útil para tal fin. Objetivo: reportar una serie de casos de niños con diagnóstico de baja talla a quienes se les indicó una endoscopia de vías digestivas altas como parte de su estudio. Reporte de casos: se incluyeron 15 niños entre los 2 y 16 años de edad, 53,3% niñas, 26,7% desnutridos según el índice de masa corporal y la talla para la edad, 66,7% con baja talla grave y 33,3% con baja talla moderada. El 53,3% presentó dolor abdominal, el 46,7% no tuvo ganancia de peso, el 26,7% tuvo inapetencia y el 13,3% tuvo vómito, entre otros. Entre el 40,0% y el 93,4% presentaron macro- o microscópicamente esofagitis, gastritis y duodenitis. Los hallazgos microscópicos más importantes fueron duodenitis crónica con giardiasis, úlceras duodenales, hiperplasia nodular linfoide duodenal, Helicobacter pylori y duodenitis crónica eosinofílica. Conclusiones: a pesar de que la endoscopia de vías digestivas es un método poco utilizado y no bien descrito en el estudio de niños con baja talla, este reporte de casos describe organicidad en un 80,0% de los niños analizados.


Abstract Introduction: The study of short stature of digestive origin in children shows no pre-established laboratory patterns. However, endoscopy of the digestive tract may be a useful tool for this purpose. Objective: To report a series of cases of children with a diagnosis of short stature who underwent upper digestive tract endoscopy as part of their study. Case report: 15 children between the ages of 2 and 16 years were included; 53.3% were girls. 26.7% presented with malnutrition according to their body mass index and height-for-age, 66.7% had short stature, and 33.3% moderate short stature. Abdominal pain was reported in 53.3% of the cases, and no weight gain in 46.7%. Other symptoms were lack of appetite in 26.7%, vomiting in 13.3%, among others. Between 40% and 93.4% of the children presented macro and/or microscopic esophagitis, gastritis, and duodenitis. The most important microscopic findings were chronic duodenitis with giardiasis, duodenal ulcers, duodenal nodular lymphoid hyperplasia, Helicobacter pylori, and chronic eosinophilic duodenitis. Conclusions: Although endoscopy of the digestive tract is a method barely used and not well described in the study of children with short stature, this case report describes organicity in 80% of the children analyzed.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Baja , Endoscopy, Gastrointestinal , Endoscopy , Body Mass Index , Duodenitis , Esophagitis , Gastritis
10.
Article in Chinese | WPRIM | ID: wpr-888185

ABSTRACT

This study investigated the protective effect of total triterpenoids from Chaenomeles speciosa against Helicobacter pylori(Hp)-induced gastritis in mice and explored its possible mechanism. The chronic atrophic gastritis(CAG) model mice were randomly divided into four groups of model, total triterpenoids from C. speciosa(50 and 100 mg·kg~(-1)) and triple therapy, with C57 BL/6 J mice without Hp infection taken as the normal group. Mice in the treatment groups were given corresponding drugs once a day for 4 weeks. Then the following indexes were detected: the contents of reactive oxygen species(ROS), monocyte chemotactic protein 1(MCP-1), keratinocyte chemokines(KC), TNF-α, IL-1β, IL-6, IL-18, IL-4 and IL-10 in blood and gastric tissue, the activities and contents of LDH, MPO, SOD, GSH-Px, CAT and MDA in gastric tissue and the activities of β-glucuronidase, β-galactosidase, cathepsins B and D in blood, gastric tissue and lysosome. Besides, the mRNA expression levels of Toll-like receptor 4(TLR4), myeloid differentiation factor 88(MyD88), Bcl-2, Bcl-xl, Bax and Bad in gastric tissue were determined by quantitative real-time PCR. Western blot was employed to detect the protein expression levels of TLR4, MyD88, p-IKKβ, p-IκBα, NOD-like receptor 3(NLRP3), apoptosis-associated speck-like protein(ASC), pro-caspase-1, caspase-1, thioredoxin-interacting protein(TXNIP), pro-IL-1β, pro-IL-18, Bcl-2, Bcl-xl, Bax, Bad, cytochrome C, apoptotic protease-activating factor-1(Apaf-1), pro-caspase-9, pro-caspase-3, cleaved-caspase-9, cleaved-caspase-3, poly(ADP-ribose) polymerase 1(PARP-1), cleaved-PARP-1 and cytosol and nucleus NF-κB p65 in gastric tissue. The results indicated that the total triterpenoids from C. speciosa significantly suppressed Hp proliferation, alleviated the damage to gastric mucosa and improved lymphocyte infiltration and gland atrophy. They were also effective in reducing the activities of β-glucuronidase, β-galactosidase, cathepsins B and D in blood and gastric tissue, elevating the activities of β-glucuronidase and cathepsin D in lysosomal organelles, decreasing the contents of ROS, MCP-1, KC, TNF-α, IL-1β, IL-6, IL-18 in blood, MDA content and MPO and LDH activities in gastric tissue and increasing the contents of IL-4 and IL-10 in blood and activities of SOD, CAT and GSH-Px in gastric tissue. Other phenomena were also observed after the treatment with total triterpenoids from C. speciosa, including the down-regulation of the mRNA and protein expression levels of TLR4, MyD88, Bax and Bad, the protein expression levels of p-IKKβ, p-IκBα, NLRP3, ASC, pro-caspase-1, caspase-1, TXNIP, pro-IL-1β, pro-IL-18, cytochrome C, Apaf-1, cleaved-caspase-9, cleaved-caspase-3, cleaved-PARP-1 and nuclear NF-κB p65, reduction of p-IKKβ/IKKβ and p-IκBα/IκBα ratios and up-regulation of the mRNA and protein expression levels of Bcl-2 and Bcl-xl, up-regulation of pro-caspase-9, pro-caspace-3, cytosol NF-κB p65 protein expression levels and Bcl-2/Bax and Bcl-xl/Bad ratios in gastric tissue. These aforementioned results suggest that the total triterpenoids from C. speciosa have significant protective effects against CAG induced by Hp, and its mechanism may be related to enhancing the function of endogenous antioxidant system, suppressing the oxidative stress and inflammatory reaction induced by Hp, correcting lysosomal dysfunction and inflammatory activation of TLR4/NF-κB/NLRP3 inflammasome signaling pathway and thus inhibiting mitochondria-mediated apoptosis.


Subject(s)
Animals , Gastritis/drug therapy , Helicobacter pylori , Mice , NF-kappa B/genetics , Rosaceae , Triterpenes
11.
Article in English | WPRIM | ID: wpr-922406

ABSTRACT

A boy, aged 17 years, was admitted again due to abdominal pain, diarrhea, and eosinophilia for 3 years, which worsened for 3 days. Three years ago, the boy suffered from abdominal pain and diarrhea after eating yogurt; color Doppler ultrasound showed a large amount of peritoneal effusion, and routine blood test, bone marrow cell morphology, and ascites histological examination showed a large number of eosinophils. Three days ago, he was admitted again due to abdominal pain and diarrhea. The gastrointestinal endoscopy showed eosinophil infiltration in the angle of stomach. The boy was diagnosed with eosinophilic gastrointestinal disease (eosinophilic gastroenteritis). He was improved after the treatment with glucocorticoids and dietary avoidance, and no recurrence was observed during the one-year follow-up. It is concluded that for children who attend the hospital due to gastrointestinal symptoms such as abdominal pain and diarrhea, if there is an increase in peripheral blood eosinophils, it is necessary to consider the possibility of eosinophilic gastrointestinal disease, and eosinophil infiltration and abnormal eosinophil count in gastrointestinal tissue based on endoscopic biopsy may be the key to diagnosis.


Subject(s)
Abdominal Pain/etiology , Ascitic Fluid , Enteritis , Eosinophilia/etiology , Gastritis , Humans , Male
12.
Article in English | WPRIM | ID: wpr-922403

ABSTRACT

OBJECTIVES@#To study the predictive factors for glucocorticoid therapy by analyzing the association between the clinical features and treatment regimens in children with eosinophilic gastroenteritis.@*METHODS@#A retrospective analysis was performed on the medical data of 182 children with eosinophilic gastroenteritis who were admitted to Guangzhou Women and Children's Medical Center from January 2012 to December 2020. According to whether glucocorticoids were used, these children were divided into a glucocorticoid treatment group and a control group. The two groups were compared in terms of age, history of allergy, clinical symptoms, laboratory examination results, endoscopic findings, and pathological results of gastrointestinal mucosa. A multivariate logistic regression analysis was performed for the results with statistical significance.@*RESULTS@#Of the 182 children, 36 (19.8%) received glucocorticoid therapy. The rates of hematochezia, anemia, and mucosal ulceration/luminal stenosis under endoscopy and the mucosal eosinophil infiltration count were significantly higher in the glucocorticoid treatment group than those in the control group (@*CONCLUSIONS@#Mucosal ulceration/luminal stenosis under endoscopy or a significant increase in the mucosal eosinophil infiltration count based on pathology suggests that glucocorticoid therapy can be considered in children with eosinophil gastroenteritis.


Subject(s)
Child , Enteritis/drug therapy , Eosinophilia/drug therapy , Female , Gastritis , Glucocorticoids/therapeutic use , Humans , Retrospective Studies
13.
Article in English | WPRIM | ID: wpr-921870

ABSTRACT

Objective To develope a deep learning algorithm for pathological classification of chronic gastritis and assess its performance using whole-slide images (WSIs). Methods We retrospectively collected 1,250 gastric biopsy specimens (1,128 gastritis, 122 normal mucosa) from PLA General Hospital. The deep learning algorithm based on DeepLab v3 (ResNet-50) architecture was trained and validated using 1,008 WSIs and 100 WSIs, respectively. The diagnostic performance of the algorithm was tested on an independent test set of 142 WSIs, with the pathologists' consensus diagnosis as the gold standard. Results The receiver operating characteristic (ROC) curves were generated for chronic superficial gastritis (CSuG), chronic active gastritis (CAcG), and chronic atrophic gastritis (CAtG) in the test set, respectively.The areas under the ROC curves (AUCs) of the algorithm for CSuG, CAcG, and CAtG were 0.882, 0.905 and 0.910, respectively. The sensitivity and specificity of the deep learning algorithm for the classification of CSuG, CAcG, and CAtG were 0.790 and 1.000 (accuracy 0.880), 0.985 and 0.829 (accuracy 0.901), 0.952 and 0.992 (accuracy 0.986), respectively. The overall predicted accuracy for three different types of gastritis was 0.867. By flagging the suspicious regions identified by the algorithm in WSI, a more transparent and interpretable diagnosis can be generated. Conclusion The deep learning algorithm achieved high accuracy for chronic gastritis classification using WSIs. By pre-highlighting the different gastritis regions, it might be used as an auxiliary diagnostic tool to improve the work efficiency of pathologists.


Subject(s)
Algorithms , Deep Learning , Gastritis/diagnosis , Humans , ROC Curve , Retrospective Studies
14.
Rev. méd. Minas Gerais ; 31: 31414, 2021.
Article in English, Portuguese | SES-MG, LILACS, SES-MG | ID: biblio-1354532

ABSTRACT

Paciente apresenta dispepsia, vômitos e dor epigástrica uma semana após EDA com biópsia. Exames revelaram elevação de marcadores inflamatórios e tomografia contrastada do abdome, um espessamento parietal circunferencial do corpo gástrico e da região antropilórica. Nova EDA mostrou lesão na grande curvatura do antro, no local onde foi realizada a biópsia endoscópica, com drenagem de secreção purulenta e enantema, condizente com diagnóstico de abscesso gástrico. Realizados antibioticoterapia e drenagem endoscópica com sinais clínicos de melhora. Terceira EDA evidenciou resolução da lesão. Paciente recebeu alta hospitalar em uso de amoxicilina e clavulanato por 10 dias.O abscesso gástrico é uma rara infecção da submucosa e da muscular própria e sua patogênese envolve foco de injúria à mucosa gástrica por trauma penetrante, disseminação de infecções contíguas, fontes de infecção ou casos idiopáticos. Desconforto epigástrico é o sintoma predominante, associado ou não a náusea, vômitos, febre e calafrios. Alterações laboratoriais incluem leucocitose com desvio à esquerda e elevação de marcadores inflamatórios. A propedêutica é realizada por meio de EDA, TC de abdome e ecoendoscopia. A cultura da drenagem purulenta é útil no diagnóstico e no tratamento, sendo o Streptococcus o patógeno mais comum. Antibioticoterapia, associada à drenagem percutânea ou endoscópica é o pilar do tratamento. Cirurgia está reservada para dúvidas diagnóstica, falha de tratamentos menos invasivos ou peritonite.Devido à raridade dos abscessos gástricos e à ausência de marcadores específicos, o diagnóstico requer um alto grau de suspeição e deve ser confirmado por exames endoscópicos e de imagem. É importante também, incluir essa condição nos diagnósticos diferenciais dos tumores intramurais gástricos.


Patient presents dyspepsia, vomiting and epigastric pain one week after upper digestive endoscopy (UDE) with biopsy. Tests revealed elevation of inflammatory markers and contrasted tomography of the abdomen, a circumferential parietal thickening of the gastric body and the anthropiloric region. New UDE showed lesion in the great curvature of the antrum, where the endoscopic biopsy was performed, with purulent secretion and enanthema, consistent with the diagnosis of gastric abscess. Antibiotic therapy and endoscopic drainage evidenced clinical signs of improvement. Third UDE showed resolution of the lesion. Patient was discharged using amoxicillin and clavulanate for 10 days.Gastric abscess is a rare infection of the submucosa and the muscle layer. The pathogenesis involves a focus of injury to the gastric mucosa by penetrating trauma, dissemination of contiguous infections, sources of infection or idiopathic cases. Epigastric discomfort is the predominant symptom, associated with nausea, vomiting and fever. Laboratory changes include leukocytosis with left shift and elevation of inflammatory markers. Propaedeutics is performed by means of UDE, abdominal CT and echoendoscopy. The culture of purulent drainage is useful in diagnosis and treatment, Streptococcus is the most common pathogen. Antibiotic therapy and percutaneous or endoscopic drainage is the mainstay of treatment. Surgery is reserved for diagnostic doubts, failure of less invasive treatments or peritonitis.Due to the rarity of gastric abscesses and the absence of specific markers, the diagnosis requires a high degree of suspicion and must be confirmed by endoscopic and imaging testes. It is also important to include this condition in the differential diagnoses of gastric intramural tumors.


Subject(s)
Female , Middle Aged , Endoscopy, Digestive System , Abdominal Abscess , Endoscopic Ultrasound-Guided Fine Needle Aspiration , Gastritis , Infections
15.
Rev. Asoc. Med. Bahía Blanca ; 31(1): 24-30, 2021.
Article in Spanish | LILACS, BINACIS, UNISALUD | ID: biblio-1293381

ABSTRACT

Se evaluó el efecto protector gástrico de la infusión de las partes aéreas de Pluchea sagittalis (Asteraceae) frente a un modelo de inducción de úlceras gástricas con etanol en ratones. Adicionalmente, se realizó un tamizaje fitoquímico para determinar los principales grupos de compuestos del extracto. Se determinaron el contenido de fenoles y flavonoides totales, como también la capacidad atrapadora de radicales libres. Los resultados indicaron que la administración oral de la infusión de la planta administrada en dosis de 50, 100 y 500 mg/kg produjo un efecto preventivo significativo sobre la generación de úlceras (P<0,05). Se observó una actividad atrapadora de radicales libres de 91,3%, junto con un contenido de fenoles y flavonoides totales de 325,5 mg/g y 3,21 mg/g de infusión respectivamente. Podemos concluir que estos metabolitos ejercen efectos protectores en modelos experimentales de inducción de úlceras a través de diferentes acciones, lo que podría explicar la actividad gastroprotectora de la planta y su uso tradicional en afecciones gastrointestinales.


The gastric protective effect of the infusion of Pluchea sagittalis (Asteraceae) aerial parts was evaluated against a model of gastric ulcer induction with ethanol in mice. Additionally, a phytochemical screening was performed to determine the main groups of compounds in the extract. The content of phenols and total flavonoids, as well as the free radical scavenging capacity, were determined. The results indicated that oral administration of the plant infusion administered in doses of 50, 100 and 500 mg/kg produced a significant preventive effect on ulcer generation (P<0.05). A free radical scavenging activity of 91.3% was observed, together with a phenol and total flavonoid content of 325.5 mg/g and 3.21 mg/g of infusion, respectively. We can conclude that these metabolites exert protective effects in experimental models of ulcer induction through different actions, which could explain the gastro protective activity of the plant and its traditional use in gastrointestinal conditions.


Subject(s)
Gastrointestinal Diseases , Mice , Ethanol , Gastritis , Medicine, Traditional
16.
Braz. j. med. biol. res ; 54(7): e10687, 2021. tab, graf
Article in English | LILACS | ID: biblio-1249315

ABSTRACT

Helicobacter pylori (H. pylori) induces an intense inflammatory response, mediated by proinflammatory cytokines, including interleukin (IL)-6 and its membrane receptor (IL-6R), which activates important signaling pathways in the development of gastric disease and cancer. We investigated the gene and protein expression of IL-6 and IL-6R and the influence of polymorphisms rs1800795, rs1800796, and rs1800797 on its gene expression together with H. pylori infection. Furthermore, an in-silico analysis was performed to support our results. Gastric biopsies were obtained from patients with gastric symptoms and patients with gastric cancer (GC) and were divided into groups (Control, Gastritis, and Cancer). H. pylori was detected by PCR. Real-time-qPCR was employed to determine gene expression, and western blot assay was used to analyze protein expression levels. PCR-RFLP was used to characterize IL-6 polymorphisms. Bioinformatics analyses were performed using the Gene Expression Omnibus (GEO) database and GEO2R to screen out differentially expressed genes (DEGs). H. pylori was detected in 43.3% of the samples. Statistically significant differences were found for IL-6 (P=0.0001) and IL-6R (P=0.0005) genes among the three groups, regardless of the presence of H. pylori. Among patients with H. pylori infection, the IL-6 and IL-6R gene and protein expressions were significantly increased, highlighting IL-6 gene overexpression in patients with GC. No statistically significant differences were found for the rs1800795, rs1800796, and rs1800797 polymorphisms compared to IL-6 gene expression. The results indicated that the IL-6 polymorphisms do not influence its expression, but IL-6 and IL-6R expression seems to be altered by the presence of H. pylori.


Subject(s)
Humans , Stomach Neoplasms/genetics , Helicobacter pylori , Helicobacter Infections/genetics , Interleukin-6/genetics , Gastritis/genetics , Interleukin-8 , Gastric Mucosa
17.
Rev. medica electron ; 42(5): 2301-2313, sept.-oct. 2020. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1144735

ABSTRACT

RESUMEN Introducción: la infección por Helicobacter pylori es una de las más prevalentes en el planeta. Supone una carga significativa para los sistemas sanitarios, debido a la elevada resistencia a antibióticos que presenta para su erradicación. Objetivo: determinar las características clínico epidemiológicas de infección por Helicobacter pylori de pacientes atendidos en Consulta Provincial de Gastroenterología. Materiales y métodos: se realizó un estudio observacional descriptivo. El universo estuvo conformado por los 167 pacientes con determinación de Helicobacter pylori positivo, por test de ureasa. Las variables a considerar fueron: la edad, el sexo, diagnóstico histológico, síntomas clínicos y la evolución clínica posterior al tratamiento específico para Helicobacter pylori. Se utilizó la técnica estadística de análisis de distribución de frecuencias. Resultados: un 59,6 % de los pacientes resultó con Helicobacter pylori positivo con predominio del sexo masculino. Fue la gastritis crónica la alteración gástrica que más se asoció a la infección. La epigastralgia y distensión abdominal resultaron los síntomas más frecuentes. Evolucionaron de forma satisfactoria el 49 % de los casos y solo un 17 % presentaron una mala respuesta al tratamiento. Conclusiones: se obtuvo un alto porcentaje de infección por Helicobacter pylori y una buena respuesta al tratamiento utilizado (AU).


ABSTRACT Introduction: the infection for Helicobacter pylori is one of the more prevalent in the world; it supposes a significant burden for the sanitary systems, due to the high resistance to antibiotics that it presents for its eradication. Objective: to determine the clinical epidemiological characteristics of the infection due to Helicobacter pylori in patients treated in the provincial consultation of Gastroenterología. Materials and methods: an observational, descriptive study was carried out in a universe formed by 167 patients with positive Helicobacter pylori determined by urease test. The variables to consider were age, sex, histologic diagnosis, clinical symptoms and clinical evolution after the specific treatment for Helicobacter pylori. The statistical technique of analysis of frequencies distribution was used. Results: 59, 6% of the patients was Helicobacter pylori positive with prevalence of the male sex; chronic gastritis was the gastric alteration more associated to the infection. Epigastralgia and abdominal distension were the most frequent symptoms. 49% of the cases evolved in a satisfactory way and only 17% answered bad to the treatment. Conclusions: a high percent of infection by Helicobacter pylori was found and also a good answer to the used treatment (AU).


Subject(s)
Humans , Male , Female , Helicobacter pylori/pathogenicity , Gastroenterology/methods , Patients , Pathological Conditions, Signs and Symptoms , Gastritis/complications , Infections/complications , Infections/parasitology , Anti-Bacterial Agents
18.
Medwave ; 20(6): e7972, 31-07-2020.
Article in English, Spanish | LILACS | ID: biblio-1118990

ABSTRACT

INTRODUCCIÓN: La gastritis crónica es unas de las enfermedades más comunes en la población y varía por regiones. Existen diversos factores que influyen en su aparición. Sin embargo, no se ha estudiado a profundidad el efecto de la altura. OBJETIVOS: Determinar la asociación entre la zona altitudinal de residencia y gastritis crónica en pacientes ambulatorios de Perú. MÉTODOS: Estudio transversal analítico. Se realizó a través del análisis secundario de datos. La variable dependiente fue gastritis crónica, tomada del reporte del paciente y verificado en la historia clínica, según antecedentes patológicos mencionados durante consulta médica. La variable independiente fue la zona altitudinal de residencia (divida en baja altitud, altitud intermedia, elevada y muy elevada). Las covariables secundarias fueron edad, sexo y tiempo viviendo en altura. Se realizaron modelos lineales generalizados para estimar razones de prevalencias, usando familia Poisson y ciudad como clúster. RESULTADOS: De los 4263 pacientes estudiados, 63% fue del sexo femenino; la mediana de la edad fue de 42 años. La prevalencia global de gastritis crónica fue 12,9%. Hubo asociación con gastritis crónica y altura de residencia a nivel intermedio, elevado, pero no con muy elevado, con una razón de prevalencia ajustada de 1,52 (intervalo de confianza 95%: 1,03 a 2,23); 2,01 (1,55 a 2,60) y 1,12 (0,84 a 1,48), respectivamente. CONCLUSIONES: Se encontró una asociación significativa entre gastritis crónica y altitud intermedia y elevada, pero no en muy elevada. Esto se explicaría por la hipoxia hipobárica en alturas, que podría conllevar lesiones en la pared gástrica, la adaptación de los peruanos a las alturas y por otras variables sociodemográficas.


INTRODUCTION: Chronic gastritis is one of the most common diseases in the population. Several factors influence its appearance; however, the effect of high altitude has not been studied thoroughly. OBJECTIVE: To determine the association between the altitude of the residential area and chronic gastritis in outpatients of Peru. METHODS: Observational, analytical, and cross-sectional study. Secondary data analysis was conducted. The dependent variable was chronic gastritis, obtained from patient references, and verified in the medical history according to the pathological history mentioned during medical consultation. The independent variable was the altitude of the residential areas (categorized into low altitude, intermediate altitude, high and very high), and the secondary co-variables were age, sex, and time living at altitude. Generalized linear models were used to estimate prevalence ratios using Poisson family and city as a cluster. RESULTS: Of the 4263 patients studied, 63% were female; the median age was 42 years. The overall prevalence of chronic gastritis was 12,9%. There was an association with chronic gastritis and altitude of residence at the intermediate and high levels, but not at the very high; with an adjusted prevalence ratio of 1.52 (95% confidence interval, 1.03 to 2.23); 2.01 (1.55 to 2.60) and 1.12 (0.84 to 1.48), respectively. CONCLUSIONS: We found a significant association between chronic gastritis and intermediate and high altitude but not at very high, which could be explained by hypobaric hypoxia in altitude that could lead to gastric wall lesions and other socio-demographic variables.


Subject(s)
Humans , Male , Female , Adult , Altitude , Gastritis/epidemiology , Peru/epidemiology , Chronic Disease , Prevalence , Cross-Sectional Studies , Gastritis/diagnosis
19.
Electron. j. biotechnol ; 45: 53-59, May 15, 2020. tab, ilus
Article in English | LILACS | ID: biblio-1177447

ABSTRACT

BACKGROUND: Helicobacter pylori is a chronic pathogenic bacteria that causes gastric mucosal damage through various host-related and pathogen-related factors. Thus, a single gene research cannot fully explain its pathogenicity. PURPOSE OF STUDY: It is necessary to establish a Helicobacter pylori pathogenic gene transcription factor regulatory network (TFRN) and study its central nodes. RESULTS: The expression data of Helicobacter pylori pathogenic genes were obtained through GEO Datasets of NCBI. The genes were screened using linear model-empirical Bayesian statistics in R language Limma package combined with the conventional t-test; the results identified 1231 differentially expressed genes. The functional analysis (gene ontology-analysis) and signal pathway analysis (pathway-analysis) of differentially expressed genes were performed using the DAVID and KEGG databases, respectively. The pathogenic gene regulatory network was constructed by integrating transcriptional regulatory element database (TRED); the disease-related analysis of the pathogenic genes was conducted using the DAVID annotation tool. Five pathogenic genes (Nos2, Il5, Colla1, Tnf, and Nfkb1) and their transcription factors (Jun, Cebpa, Egrl, Ppara, and Il6) were found to suppress the host immune function and enhance the pathogenicity of Helicobacter pylori by regulating the host immune system. CONCLUSIONS: This effect was largely mediated via three signaling pathways: Tnf pathway, PI3K Akt pathway, and Jak­STAT pathway. The pathogenicity of Helicobacter pylori is closely related to the body's immune and inflammatory system. A better understanding of the correlation of the pathogenic factors with the host immune and inflammatory factors may help to determine the precise pathogenic mechanism of H. pylori infection.


Subject(s)
Helicobacter pylori/genetics , Helicobacter pylori/pathogenicity , Computational Biology , Transcription Factors , Cytokines , Virulence Factors , Gastritis/immunology , Gastritis/microbiology , Genes, Bacterial , Immune System , Inflammation
20.
Medicina (B.Aires) ; 80(2): 111-116, abr. 2020. ilus, tab
Article in Spanish | LILACS | ID: biblio-1125050

ABSTRACT

La resistencia bacteriana a ciertos antibióticos condiciona el éxito del tratamiento erradicador de la infección gástrica por Helicobacter pylori y es motivo de creciente preocupación a nivel mundial. Dada la escasa evidencia publicada en Argentina sobre este tema, nuestro objetivo fue investigar factores asociados a la persistencia de H. pylori post-tratamiento antibiótico. Se determinó la frecuencia de fracaso terapéutico en 81 pacientes con gastritis por H. pylori tratados en nuestro Servicio y sometidos al estudio de urea en aire espirado para confirmar la erradicación de la infección. La edad promedio fue 58±12 y 43.2% eran hombres. La frecuencia de fracaso terapéutico fue 17.3%. De los dos esquemas más utilizados, la frecuencia de fracaso fue mayor con claritromicina + amoxicilina que con levofloxacina + amoxicilina (25% vs. 6.6%, p=0.04). Como factores de riesgo investigamos las siguientes variables: edad, género, síntomas, tabaquismo, consumo de anti-inflamatorios, diabetes, obesidad, tipo y duración de tratamiento. En el análisis univariado, el uso de esquemas con claritromicina y el género masculino se asociaron significativamente a persistencia de la infección [OR 4.2 (1.1-15.6) y 5.2 (1.1-26.4)]. En el análisis multivariado, el uso de esquema con claritromicina permaneció asociado al fracaso terapéutico [OR 5.38 (1.1-29.5)]. Concluimos que la inclusión de claritromicina en el esquema terapéutico para la gastritis por H. pylori se asoció a mayor fracaso terapéutico. Este fracaso es atribuible a alta prevalencia de resistencia de H. pylori a ese antibiótico en la población atendida en nuestro hospital y cuestiona las prácticas habituales de tratamiento en nuestro medio.


Antibiotic resistance may hinder the efficacy of eradication therapy against Helicobacter pylori infection and it has become a major concern worldwide. Due to the relatively scarce evidence published in Argentina on this topic, our aim was to describe factors associated with H. pylori persistence after antibiotic treatment. The therapeutic failure rate was described among 81 patients with H. pylori gastritis treated in our Hospital with a post-treatment urea breath test to determine successful eradication. Mean age was 58 ± 12 and 43.2% were male subjects. H. pylori persistence was observed in 17.3% of subjects. Therapeutic failure was more common among patients receiving clarithromycin + amoxicillin therapy that among those receiving levofloxacin + amoxicillin (25% vs. 6.6%, p = 0.04). The following variables were assessed: age, gender, referral symptoms, smoking, anti-inflammatory use, diabetes, obesity, treatment type and duration. Clarithromycin-based therapy and male gender were associated with infection persistence on univariate analysis [OR 4.2 (1.1-15.6) and 5.2 (1.1-26.4)]. On multivariate analysis, clarithromycin-based was associated with infection persistence [5.38 (1.1-29.5)]. We conclude that clarithromycin-based therapy is significantly associated with treatment failure. This failure may be due to an elevated prevalence of H. pylori resistance to clarithromycin in the population under study and raises the question on the utility of such therapeutic alternative.


Subject(s)
Humans , Male , Female , Middle Aged , Helicobacter Infections/drug therapy , Drug Resistance, Bacterial , Gastritis/drug therapy , Anti-Bacterial Agents/therapeutic use , Argentina , Cross-Sectional Studies , Retrospective Studies , Helicobacter pylori , Helicobacter Infections/microbiology , Treatment Failure , Clarithromycin/therapeutic use , Drug Therapy, Combination , Levofloxacin/therapeutic use , Gastritis/microbiology , Amoxicillin/therapeutic use
SELECTION OF CITATIONS
SEARCH DETAIL