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1.
Rev. inf. cient ; 100(4): e3495, 2021. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1289650

ABSTRACT

RESUMEN Introducción: La infección por Helicobacter pylori es cada vez más frecuente en los jóvenes peruanos e incrementa su riesgo de padecer neoplasias gástricas. Objetivo: Determinar los hábitos alimentarios y de higiene asociados a la seroprevalencia de infección por Helicobacter pylori en estudiantes universitarios del departamento de Cajamarca, Perú, durante los meses de septiembre a octubre de 2019. Método: Estudio observacional, transversal, prospectivo con un diseño no experimental. La población estuvo conformada por 367 estudiantes de la carrera profesional de Tecnología Médica. El tamaño de la muestra fue de 188 estudiantes de ambos géneros. Se detectaron anticuerpos IgG frente a Helicobacter pylori en suero, mediante el método de inmunocromatografía. Los hábitos alimentarios y de higiene se recopilaron utilizando una encuesta estructurada. Resultados: El 51,1 % de estudiantes presentó anticuerpos IgG frente a Helicobacter pylori. El 31,38 % de los estudiantes que consumía "a veces" alimentos elaborados en la calle resultaron seropositivos a Helicobacter pylori. Aquellos estudiantes que manifestaron lavarse las manos "a veces" (29,79 %) y "siempre" (21,28 %) antes de ingerir los alimentos presentaron anticuerpos IgG contra la bacteria. Además, los estudiantes seropositivos frente a Helicobacter pylori lavaban sus frutas y verduras con el agua del grifo (43,62 %) y consumían agua de grifo no tratada (29,79 %). Conclusión: El consumo de alimentos preparados en la calle, lavado de manos antes de consumir alimentos, tipo de agua para consumo y lavado de frutas y verduras antes de ingerirlas son hábitos alimentarios y de higiene asociados a la seroprevalencia de Helicobacter pylori.


ABSTRACT Introduction: Helicobacter pylori infection is becoming more frequent in the young population of Peru and at the same time increases the risk of gastric neoplasms. Objective: To identify the dietary and higiene habits associated with the seroprevalence of Helicobacter pylori infection in university students at the Cajamarca Department. Assesed period from September throughout October 2019. Method: An observational, cross-sectional, prospective study with a non-experimental design was carried out. A population of 367 students on Medical technology career were involved and 188 of them, in both sex, were selected as trial. It was detected, using the immunochromatography method in serum assay, IgG antibodies against Helicobacter pylori. Dietary and hygiene habits were collected using a well-structed enquiry. Results: It was identified IgG antibodies against Helicobacter pylori infection in 51.1% of students. The 31.38% of those who, not frequently, had consumed food prepared outdoors were seropositive for Helicobacter pylori. Those students who revealed wash their hands, not frequently (29.79%) and frequently (21.28%) before eating, produced antibodies against this bacterial infection. In addition, Helicobacter pylori seropositive students washed their fruits and vegetables with obtained water from the tap (43.62%) and consumed untreated water fom the tap too (29.79%). Conclusions: Food intake outdoors, wash of hands, fruits and vegetables before eating, and the quality of water to be consumption are dietary and hygiene habits associated with the Helicobacter pylori seroprevalence.


RESUMO Introdução: A infecção por Helicobacter pylori é cada vez mais comum em jovens peruanos e aumenta o risco de neoplasias gástricas. Objetivo: Determinar os hábitos alimentares e de higiene associados à soroprevalência da infecção por Helicobacter pylori em universitários do departamento de Cajamarca, Peru, durante os meses de setembro a outubro de 2019. Método: Estudo observacional, transversal, prospectivo com um não experimental. A população foi composta por 367 alunos da carreira de Tecnologia Médica. O tamanho da amostra foi de 188 alunos de ambos os sexos. Os anticorpos IgG contra Helicobacter pylori foram detectados no soro pelo método de imunocromatografia. Os hábitos alimentares e de higiene foram coletados por meio de questionário estruturado. Resultados: 51,1% dos alunos apresentaram anticorpos IgG contra Helicobacter pylori. 31,38% dos alunos que comeram "às vezes" alimentos preparados na rua eram soropositivos para Helicobacter pylori. Os alunos que relataram lavar as mãos "às vezes" (29,79%) e "sempre" (21,28%) antes de comer apresentaram anticorpos IgG contra a bactéria. Além disso, os alunos soropositivos para Helicobacter pylori lavavam frutas e vegetais com água da torneira (43,62%) e consumiam água da torneira não tratada (29,79%). Conclusão: O consumo de alimentos preparados na rua, a lavagem das mãos antes de consumir os alimentos, o tipo de água para consumo e a lavagem de frutas e verduras antes de ingeri-los são hábitos alimentares e de higiene associados à soroprevalência do Helicobacter pylori.


Subject(s)
Humans , Food Hygiene , Helicobacter pylori/isolation & purification , Feeding Behavior , Peru , Students , Cross-Sectional Studies , Prospective Studies , Biomedical Technology/education , Observational Study
2.
Rev. chil. pediatr ; 91(5): 809-827, oct. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1144282

ABSTRACT

Resumen: Introducción: Las últimas guías clínicas conjuntas de NASPGHAN y ESPGHAN en relación a la infección por H. pylori publicadas el año 2016, contienen 20 afirmaciones que han sido cuestionadas en la práctica respecto a su aplicabilidad en Latinoamérica (LA); en particular en relación a la preven ción del cáncer gástrico. Métodos: Se realizó un análisis crítico de la literatura, con especial énfasis en datos de LA y se estableció el nivel de evidencia y nivel de recomendación de las afirmaciones mas controversiales de las Guías Conjuntas. Se realizaron 2 rondas de votación de acuerdo a la técnica Delfi de consenso y se utilizó escala de Likert (de 0 a 4) para establecer el "grado de acuerdo" entre un grupo de expertos de SLAGHNP. Resultados: Existen pocos estudios en relación a diagnóstico, efectividad de tratamiento y susceptibilidad a antibióticos de H. pylori en pacientes pediátricos de LA. En base a estos estudios, extrapolaciones de estudios de adultos y la experiencia clínica del panel de expertos participantes, se realizan las siguientes recomendaciones. Recomendamos la toma de biopsias para test rápido de ureasa e histología (y muestras para cultivo o técnicas moleculares, cuando estén disponibles) durante la endoscopia digestiva alta sólo si en caso de confirmar la infección por H. pylori, se indicará tratamiento de erradicación. Recomendamos que centros regionales seleccio nados realicen estudios de sensibilidad/resistencia antimicrobiana para H. pylori y así actúen como centros de referencia para toda LA. En caso de falla de erradicación de H. pylori con tratamiento de primera línea, recomendamos tratamiento empírico con terapia cuádruple con inhibidor de bomba de protones, amoxicilina, metronidazol y bismuto por 14 días. En caso de falla de erradicación con el esquema de segunda línea, se recomienda indicar un tratamiento individualizado considerando la edad del paciente, el esquema indicado previamente y la sensibilidad antibiótica de la cepa, lo que implica realizar una nueva endoscopía con extracción de muestra para cultivo y antibiograma o es tudio molecular de resistencia. En niños sintomáticos referidos a endoscopía que tengan antecedente de familiar de primer o segundo grado con cáncer gástrico, se recomienda considerar la búsqueda de H. pylori mediante técnica directa durante la endoscopia (y erradicarlo cuando es detectado). Con clusiones: La evidencia apoya mayoritariamente los conceptos generales de las Guías NASPGHAN/ ESPGHAN 2016, pero es necesario adaptarlas a la realidad de LA, con énfasis en el desarrollo de centros regionales para el estudio de sensibilidad a antibióticos y mejorar la correcta selección del tratamiento de erradicación. En niños sintomáticos con antecedente familiar de primer o segundo grado de cáncer gástrico, se debe considerar la búsqueda y erradicación de H. pylori.


Abstract: Introduction: The latest joint H. pylori NASPGHAN and ESPGHAN clinical guidelines published in 2016, contain 20 statements that have been questioned in practice regarding their applicability in Latin America (LA); in particular in relation to gastric cancer prevention. Methods: We conduc ted a critical analysis of the literature, with special emphasis on LA data and established the level of evidence and level of recommendation of the most controversial claims in the Joint Guidelines. Two rounds of voting were conducted according to the Delphi consensus technique and a Likert scale (from 0 to 4) was used to establish the "degree of agreement" among a panel of SLAGHNP ex perts. Results: There are few studies regarding diagnosis, treatment effectiveness and susceptibility to antibiotics of H. pylori in pediatric patients of LA. Based on these studies, extrapolations from adult studies, and the clinical experience of the participating expert panel, the following recom mendations are made. We recommend taking biopsies for rapid urease and histology testing (and samples for culture or molecular techniques, when available) during upper endoscopy only if in case of confirmed H. pylori infection, eradication treatment will be indicated. We recommend that selected regional centers conduct antimicrobial sensitivity/resistance studies for H. pylori and thus act as reference centers for all LA. In case of failure to eradicate H. pylori with first-line treatment, we recommend empirical treatment with quadruple therapy with proton pump inhibitor, amoxi cillin, metronidazole, and bismuth for 14 days. In case of eradication failure with the second line scheme, it is recommended to indicate an individualized treatment considering the age of the pa tient, the previously indicated scheme and the antibiotic sensitivity of the strain, which implies performing a new endoscopy with sample extraction for culture and antibiogram or molecular resistance study. In symptomatic children referred to endoscopy who have a history of first or se cond degree family members with gastric cancer, it is recommended to consider the search for H. pylori by direct technique during endoscopy (and eradicate it when detected). Conclusions: The evidence supports most of the general concepts of the NASPGHAN/ESPGHAN 2016 Guidelines, but it is necessary to adapt them to the reality of LA, with emphasis on the development of regional centers for the study of antibiotic sensitivity and to improve the correct selection of the eradication treatment. In symptomatic children with a family history of first or second degree gastric cancer, the search for and eradication of H. pylori should be considered.


Subject(s)
Humans , Child, Preschool , Child , Adolescent , Endoscopy, Digestive System/standards , Helicobacter pylori/isolation & purification , Helicobacter Infections/diagnosis , Helicobacter Infections/pathology , Helicobacter Infections/prevention & control , Helicobacter Infections/drug therapy , Proton Pump Inhibitors/therapeutic use , Anti-Bacterial Agents/therapeutic use , Pediatrics/methods , Pediatrics/standards , Stomach/pathology , Stomach/diagnostic imaging , Biopsy , Microbial Sensitivity Tests/standards , Endoscopy, Digestive System/methods , Delphi Technique , Treatment Outcome , Drug Therapy, Combination , Latin America
3.
Braz. j. otorhinolaryngol. (Impr.) ; 86(2): 217-221, March-Apr. 2020. tab, graf
Article in English | LILACS | ID: biblio-1132581

ABSTRACT

Abstract Introduction: It is proposed that Helicobacter pylori can be responsible for the development of otitis media with effusion. Objective: The aim of this study is to investigate the prevalence of H. pylori in the adenoid tissue and fluid of the middle ear in patients who suffer from adenoid hyperplasia and otitis media with effusion in comparison with those who suffer from adenoid hyperplasia without otitis media with effusion. Methods: This is a case-control study that was carried out in 50 children of age 2-7 years old who were admitted with adenoid hyperplasia. Patients were divided into case and control groups. The study group included 25 patients with adenoid hyperplasia and otitis media with effusion and the control group included 25 patients with adenoid hyperplasia without otitis media with effusion. The patients in both groups underwent surgical adenoidectomy. For the case group we carried out myringotomy and placement of tympanostomy tube, and fluid samples were collected under sterile conditions. The samples were sent to the laboratory for polymerase chain reactions. Results: In the case group H. pylori was found to be positive in 18 samples of the middle ear fluid (70%) and in 1 polymerase chain reaction adenoid tissue sample (4%). In the control group H. pylori was positive in 3 samples of adenoid tissues (12%). There was no gender difference. Conclusion: H. pylori is one of the important bacteria that plays a role in the pathogenesis of otitis media with effusion. Whether adenoid tissue may be a reservoir for H. Pylori is unclear.


Resumo Introdução: Propõe-se que o Helicobacter pylori possa ser responsável pelo desenvolvimento de otite média com efusão. Objetivo: Investigar a prevalência de H. pylori no tecido adenoideano e no fluido da orelha média em pacientes com hiperplasia de adenoide e otite média com efusão em comparação àqueles com hiperplasia de adenoide sem otite média com efusão. Método: Este é um estudo de caso-controle feito em 50 crianças de 2 a 7 anos, com sinais e sintomas de hiperplasia de adenoide. Os pacientes foram divididos em grupo de estudo e grupo controle. O grupo de estudo incluiu 25 pacientes com hiperplasia de adenoide e otite média com efusão e o grupo controle incluiu 25 pacientes com hiperplasia de adenoide sem otite média com efusão. Os pacientes dos dois grupos foram submetidos a adenoidectomia e, no grupo de estudo, realizou-se também miringotomia com colocação de tubo de ventilação e amostras de fluidos foram coletadas sob condições estéreis. As amostras foram enviadas para o laboratório, para investigação por reação de polimerase em cadeia. Resultados: No grupo de estudo, houve positividade para H. pylori em 18 amostras do fluido de orelha média (70%) e uma amostra de tecido adenoideano foi positiva na reação de polimerase em cadeia (4%). No grupo controle, houve positividade para H. pylori em 3 amostras de tecido adenoideano (12%). Não houve diferença entre os gêneros. Conclusão: H. pylori é uma das bactérias importantes que desempenham um papel na patogênese da otite médica com efusão. Se o tecido adenoideano pode ou não representar um reservatório para H. pylori ainda necessita ser esclarecido.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Otitis Media with Effusion/microbiology , DNA, Bacterial/genetics , Helicobacter pylori/genetics , Helicobacter Infections/diagnosis , Case-Control Studies , Polymerase Chain Reaction , Helicobacter pylori/isolation & purification
4.
Int. j. odontostomatol. (Print) ; 14(1): 131-135, mar. 2020. tab, graf
Article in English | LILACS | ID: biblio-1056512

ABSTRACT

ABSTRACT: Oral Lichen planus (OLP) is one of the main inflammatory diseases of the oral mucosa that is considered as a potentially malignant disorder. The exact pathogenesis of OLP remains to be completely understood. However, presence of bacteria has been associated to the inflammatory response observed in OLP. Particularly, Helicobacter pylori a major etiological agent of gastrointestinal inflammatory diseases and risk factor for gastric cancer, has been associated to Lichen planus. Here we studied a group of Chilean patients if there is any association between the presence of Helicobacter pylori and the clinical manifestation of OLP. We found a significant difference between the patients positive for H. pylori and the age of OLP diagnosis, suggesting that oral H. pylori might induce the disease at an earlier age. However, we could not confirm a statistically significance between the presence of the bacteria and OLP.


RESUMEN: Liquen Plano Oral (LPO) es una enfermedad inflamatoria de la mucosa oral considerada como desorden potencialmente maligno. La patogénesis exacta de LPO es desconocida. Sin embargo, se ha asociado la presencia de bacterias como responsables de la inflamación observada en LPO. Particularmente, Helicobacter pylori (H. pylori), agente etiológico principal de enfermedades inflamatorias gastrointestinales y factor de riesgo de cáncer gástrico, ha sido asociado con LPO. Se estudió la posible asociación entre H. pylori y manifestaciones clínicas de LPO en un grupo de pacientes Chilenos. Se encontró diferencia significativa entre los pacientes positivos para H. pylori y la edad de diagnóstico de LPO, sugiriendo que H. pylori podría inducir la enfermedad a temprana edad. Sin embargo, no se pudo confirmar significancia estadística entre la presencia de esta bacteria y la presencia de displasia en LPO.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Helicobacter pylori/isolation & purification , Lichen Planus, Oral/physiopathology , Lichen Planus, Oral/microbiology , Mouth/microbiology , Saliva/microbiology , Chile , Gene Amplification , Statistics, Nonparametric , Nucleic Acid Amplification Techniques
6.
ABCD arq. bras. cir. dig ; 33(2): e1506, 2020. tab, graf
Article in English | LILACS | ID: biblio-1130535

ABSTRACT

ABSTRACT Background: Acid inhibition from chronic proton pump inhibitor use and a possible increase in gastrin can lead to changes in the regulation of hydrochloric acid production. However, it has not known whether such chronic use changes the presence of gastrin, delta, and enterochromaffin-like cells in the stomach or the relationship between gastrin and delta cells. Aim: To analyze the number of gastrin-producing gastrin cells, somatostatin-producing cells, and histamine-producing cells in patients who were chronic users of proton pump inhibitor, with or without related Helicobacter pylori infection. Methods: Biopsies from 105 patients, including 81 chronic proton pump inhibitor users (experimental group) and 24 controls, were processed immunohistochemically and subjected to counting of gastrin, delta, and enterochromaffin-like cells in high-magnification microscopic fields and in 10 glands. Results: Gastrin cell, delta cell, and enterochromaffin-like cells counts were similar across the groups and appeared to be unaffected by Helicobacter pylori infection. The ratio between gastrin cells and delta cells was higher in the chronic users of proton pump inhibitor group than in controls. Conclusion: Chronic users of proton pump inhibitor does not affect gastrin cell, delta cell, and enterochromaffin-like cell counts significantly, but may alter the ratio between gastrin cells and delta cells.


RESUMO Racional: A inibição ácida pelo uso crônico de inibidores de bomba de prótons e o possível aumento da gastrina podem ser seguidos de alterações na regulação da produção do ácido clorídrico. Ainda não está definido se o uso crônico altera a quantidade de células G, D e ECL no estômago ou a razão células G/D. Objetivo: Avaliar o número de células G - produtoras de gastrina -, células D - produtoras de somatostatina - e células ECL - produtoras de histamina -, em pacientes com uso crônico de inibidores de bomba de prótons, com ou sem infecção pelo Helicobacter pylori. Método: Trata-se de estudo retrospectivo avaliando 105 pacientes, 81 usadores crônicos de inibidores de bomba de prótons e 24 controles, através de biópsias com contagem das células G, D e ECL por estudo imunoistoquímico, de forma quantitativa onde havia maior número de células positivas por campo microscópico de grande aumento e em 10 glândulas. Resultados: Não houve diferença estatística comparando-se o número de células G, D e ECL. A razão entre as células G e D foi maior nos pacientes usadores crônicos de inibidores de bomba de prótons. Conclusão: O uso crônico de inibidores de prótons parece não interferir na contagem das células G, D e ECL, porém, interfere na razão entre as células G e D.


Subject(s)
Humans , Stomach Diseases/chemically induced , Gastrins/blood , Helicobacter pylori/isolation & purification , Helicobacter Infections/therapy , Proton Pumps/metabolism , Enterochromaffin-like Cells/metabolism , Proton Pump Inhibitors/therapeutic use , Stomach , Stomach Diseases/blood , Gastrins/physiology , Case-Control Studies , Helicobacter Infections/diagnosis , Enterochromaffin-like Cells/drug effects , Proton Pump Inhibitors/adverse effects
7.
Rev. méd. Chile ; 147(11): 1382-1389, nov. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1094167

ABSTRACT

Background Chile has one of the highest mortality rates by gastric cancer (GC) worldwide. Primary prevention of GC and detection of pre-neoplastic and early neoplastic lesions should be a national priority. Aim To assess the impact of the protocolization of endoscopy referral and the use of H. pylori stool antigen test (HPSA) in the management of dyspepsia to decrease the waiting list for endoscopy and increase the detection of gastric pre-neoplastic and early neoplastic lesions. Material and Methods We included all patients referred to the Endoscopy Unit of a regional hospital, from January 2015 to December 2017. We also included patients with known pre-neoplastic lesions and all those with first degree relatives with GC. We implemented protocols for referral of patients with dyspepsia considering the use of HPSA test, prioritizing to endoscopy those with a higher risk of GC. Results A total of 4,641 endoscopies and 2,631 HPSA tests were carried out. After the adoption of these protocols, we observed a 52% decrease in the waiting time for endoscopy. The GC detection rate in this period was 1.8 to 3.1 cases per 100 endoscopies. After the adoption of the protocols, we observed a significant increase in early GC detection rate (from none in 2015 to 13% in 2017, p = 0.03). Conclusions The protocolization of the referral for endoscopy associated with widespread use of HPSA test in the management of patients with dyspepsia, are successful strategies to decrease waiting lists for endoscopy and optimize the detection rate of pre-neoplastic lesions and early GC.


Subject(s)
Humans , Precancerous Conditions/diagnosis , Waiting Lists , Helicobacter pylori/isolation & purification , Helicobacter Infections/diagnosis , Dyspepsia/diagnosis , Feces/microbiology , Antigens, Bacterial/analysis , Precancerous Conditions/microbiology , Primary Health Care , Referral and Consultation , Helicobacter Infections/complications , Helicobacter Infections/microbiology , Sensitivity and Specificity , Early Diagnosis , Dyspepsia/microbiology , Endoscopy/statistics & numerical data
8.
Rev. Col. Bras. Cir ; 46(1): e2068, 2019. tab, graf
Article in Portuguese | LILACS | ID: biblio-990362

ABSTRACT

RESUMO Objetivo: comparar o polimorfismo dos genes Glutationa S-transferase teta 1 (GSTT1) e Glutationa S-transferase mu 1 (GSTM1) da área do tumor com as margens proximal e distal de espécimes de estômago ressecados de pacientes com câncer gástrico, e investigar a presença do DNA do vírus Epstein-Barr (EBV) e Helicobacter pylori. Métodos: coletamos prospectivamente amostras teciduais da área do tumor e das margens de ressecção proximal e distal dos estômagos de dez pacientes com adenocarcinoma gástrico submetidos à gastrectomia com linfadenectomia D2 e submetemos esses espécimes à extração de DNA. Comparamos a área do tumor com as margens proximal e distal dos estômagos ressecados para o polimorfismo dos genes GSTT1 e GSTM1 e investigamos a presença de DNA do EBV e H. pylori. Utilizamos o exon 5 do gene p53 como controle interno da reação de PCR multiplex. Resultados: em um paciente, detectamos genótipos GSTT1 e GSTM1 nulos na área do tumor, em contraste com a presença de ambos os genes nas margens proximal e distal. Encontramos DNA do EBV e H. pylori na área do tumor e também nas margens proximal e distal. Em outro paciente, a margem proximal foi negativa para GSTT1 e o DNA do EBV foi negativo na margem distal. Em três pacientes, o EBV-DNA foi negativo apenas na margem distal. Conclusão: este é o primeiro relato em que diferentes genótipos, infecção por EBV-DNA e H. pylori foram observados no mesmo paciente, indicando provável deleção desses genes em resposta à progressão tumoral e heterogeneidade intratumoral.


ABSTRACT Objective: to compare the polymorphism of the Glutathione S-transferase theta 1 (GSTT1) and Glutathione S-transferase mu 1 (GSTM1) genes from the tumor area with the proximal and distal margins of stomach specimens resected from patients with gastric cancer, and to investigate the presence of Epstein-Barr virus (EBV) DNA and Helicobacter pylori. Methods: we prospectively collected tissue specimens from the tumor area and from the proximal and distal resection margins of the stomachs of ten patients with gastric adenocarcinoma who underwent gastrectomy with D2 lymphadenectomy, and submitted these specimens to DNA extraction. We compared the tumor area with the proximal and distal margins of the resected stomachs for polymorphism of GSTT1 and GSTM1 genes and investigated the presence of EBV-DNA and H. pylori. We used the p53 exon 5 gene as an internal control of the multiplex PCR reaction. Results: in one patient, we detected null GSTT1 and GSTM1 genotypes in the tumor area, in contrast to the presence of both genes in the proximal and distal margins. We found EBV-DNA and H. pylori in the tumor area and also in the proximal and distal margins. In another patient, the proximal margin was negative for GSTT1, and EBV-DNA was negative in the distal margin. In three patients, EBV-DNA was negative only in the distal margin. Conclusion: this is the first report where different genotypes, EBV-DNA and H. pylori infection were observed in the same patient, indicating a probable deletion of these genes in response to tumor progression and intratumoral heterogeneity.


Subject(s)
Humans , Male , Female , Aged , Polymorphism, Genetic/genetics , Stomach Neoplasms/surgery , Adenocarcinoma/surgery , Helicobacter pylori/genetics , Herpesvirus 4, Human/genetics , Stomach Neoplasms/enzymology , Stomach Neoplasms/microbiology , Stomach Neoplasms/virology , Adenocarcinoma/enzymology , Adenocarcinoma/microbiology , Adenocarcinoma/virology , Polymerase Chain Reaction , Prospective Studies , Risk Factors , Helicobacter pylori/isolation & purification , Herpesvirus 4, Human/isolation & purification , Genotype , Glutathione Transferase/genetics , Middle Aged
9.
Rev. Assoc. Med. Bras. (1992) ; 64(10): 928-935, Oct. 2018. tab, graf
Article in English | LILACS | ID: biblio-976778

ABSTRACT

SUMMARY BACKGROUND: There is evidence of detection of Helicobacter pylori (H. pylori) in the stool of newborns and in the yeast that colonizes the oral cavity of this age group. However, there is a lack of research to confirm it. This study proposes to determine the existence of the bacteria at an early age, specifically in newborns. OBJECTIVE: To identify intracellular H. pylori in oral yeasts and to detect antigens of the bacteria in newborn stools. METHODOLOGY: Cross-sectional and descriptive study. Samples were obtained from infants (oral swab and meconium). Identification of yeast species was performed using the following techniques: CHROMagar Candida, Germinal Tube Test and API Candida Identification System, then the yeasts were observed by light microscopy and fluorescence. Detection of H. pylori antigen in meconium and PCR were performed to amplify specific genes of the bacterium (rRNA16S, cagA, vacA s1a, vacA s1b, vacA s2, vacA m1, vacA m2 and dupA). RESULTS: Intracellular H. pylori was detected in yeast of the species Candida glabrata (C. glabrata) isolated from an oral swab of a newborn. CONCLUSION: The results of this study evidenced the existence of intracellular H. pylori in newborns.


RESUMO ANTECEDENTES: Há evidências de detecçâo de Helicobacter pylori (H. pylori) em fezes de recém-nascidos, como também dentro de leveduras que colonizam a cavidade oral dessa faixa etária. No entanto, faltam investigações que confirmem esses achados. OBJETIVO: Identificar H. pylori intracelular em leveduras de origem oral e detectar antígenos dessa bactéria em fezes neonatais. METODOLOGIA: Estudo transversal e descritivo. As amostras foram obtidas de bebês (zaragatoa oral e mecônio). As identificações das espécies de leveduras foram realizadas utilizando as seguintes técnicas: CHROMagar Candida, teste de tubo germinativo e sistema de identificação API Cândida. As leveduras foram observadas por microscopía óptica e fluorescência. Realizou-se a detecçâo de antígeno de H. pylori em mecônio e PCR para a amplificação de genes específicos desta bactéria (rRNA16S, cagA, vacA s1a, vacA s1b, vacA s2, vacA m1, vacA m2 e dupA). RESULTADOS: Foi detectado H. pylori intracelular em leveduras da espécie Candida glabrata (C. glabrata) isoladas a partir de zaragatoas oral de um recém-nascido. CONCLUSÃO: Os resultados deste estudo evidenciaram a existência interna de levedura de H. pylori em recém-nascidos.


Subject(s)
Humans , Infant, Newborn , Saliva/microbiology , Helicobacter pylori/isolation & purification , Helicobacter Infections/microbiology , Candida glabrata/isolation & purification , Feces/microbiology , Mouth Mucosa/microbiology , Polymerase Chain Reaction , Cross-Sectional Studies , Helicobacter pylori/genetics , Genotype , Antigens, Bacterial
10.
Säo Paulo med. j ; 136(5): 442-448, Sept.-Oct. 2018. tab
Article in English | LILACS | ID: biblio-979386

ABSTRACT

ABSTRACT BACKGROUND: Serological tests are practical, with low cost, but no noninvasive tests are available for diagnosing Helicobacter pylori (H. pylori) infection in Brazil. The aim here was to develop and validate enzyme-linked immunosorbent assay (ELISA) serological tests to detect anti-H. pylori immunoglobulin G antibodies, based on cultured strains from Brazilian patients. DESIGN AND SETTING: Cross-sectional, diagnostic accuracy study comparing a locally developed and validated ELISA and invasive tests among dyspeptic patients at two public hospitals in São Paulo, Brazil. METHODS: An ELISA test was prepared using whole-cell antigen from 56 strains. After genotypic characterization, it was standardized and optical density (OD) cutoffs were determined based on the serum antibody response of 100 H. pylori-negative samples, compared with 82 H. pylori-positive samples. Validation was performed on 174 symptomatic patients. RESULTS: The optimal OD cutoffs established (for monoclonal and polyclonal tests, respectively) were 0.167 and 0.164; overall ELISA sensitivity: 84.3%, 78.9%; specificity: 88.6%, 90.6%; positive predictive value (PPV): 75.4%, 80%; negative predictive value (NPV): 93.1%, 81.8%; accuracy: 87.3%, 86.2%; child and adolescent ELISA sensitivity: 74.2%, 81.8%; specificity: 90.8%, 86.7%; PPV: 66.6%, 84.3%; NPV: 95.8%, 84.8%; accuracy: 88.5%, 84.6; adult ELISA sensitivity: 84.4%, 75%; specificity: 86.9%, 93%; PPV: 81.8%, 78.3%; NPV: 88.9%, 91.8%; accuracy: 85.9%, 88.5%. CONCLUSION: The polyclonal serological test developed using local strains presented better diagnostic performance among children and adolescents, while the monoclonal test was better among adults. The results from both tests suggest that these in-house serological tests could be used to detect anti-H. pylori antibodies in our population, for screening purposes.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Enzyme-Linked Immunosorbent Assay/methods , Helicobacter pylori/isolation & purification , Helicobacter Infections/diagnosis , Serum Bactericidal Antibody Assay/standards , Reference Standards , Stomach/microbiology , Stomach/pathology , Enzyme-Linked Immunosorbent Assay/standards , Polymerase Chain Reaction , Cross-Sectional Studies , Reproducibility of Results , Helicobacter pylori/immunology , Helicobacter Infections/microbiology , Sensitivity and Specificity , Antibodies, Bacterial/blood
11.
Arq. gastroenterol ; 55(3): 212-215, July-Sept. 2018. tab
Article in English | LILACS | ID: biblio-973892

ABSTRACT

ABSTRACT BACKGROUND: Gastritis is a very common disorder that is widely distributed worldwide, representing one of the most prevalent pathological entities in Gastroenterology and Digestive Endoscopy. OBJECTIVE: This study aims to analyze the correlation between the endoscopic findings and the histological diagnosis of antral gastritis. METHODS: In this study, 92 reports of upper digestive endoscopy were performed between November 2014 and January 2015, including biopsy of the antral gastric mucosa, comparing the endoscopic and histological findings, which were classified according to the Sidney System. The 92 exams included 35 men and 57 women, ranging in age from 15 to 84 years. The most frequent indication was epigastric pain. RESULTS: Of the 92 examinations analyzed, the histological diagnosis of antral gastritis appeared in 75 exams, 59 endoscopic reports contained the diagnosis of antral gastritis, and 33 endoscopic findings were normal. The kappa coefficient was 0.212 (P<0.05), indicating that there was no significant agreement between the endoscopic findings and the histological diagnosis of antral gastritis. CONCLUSION: We conclude that histology represents the gold standard method for the diagnosis of antral gastritis and that in daily clinical practice, biopsies should always be performed, regardless of the endoscopic findings.


RESUMO CONTEXTO: Gastrite é uma afecção muito comum, de larga distribuição mundial, representando uma das entidades patológicas mais prevalentes em Gastroenterologia e Endoscopia Digestiva. OBJETIVO: Este estudo tem por objetivo analisar a correlação entre os achados endoscópicos e o diagnóstico histológico de gastrite antral. MÉTODOS: Nesse estudo, foram analisados 92 laudos de endoscopia digestiva alta, realizados entre novembro de 2014 e janeiro de 2015, que continham biópsia de mucosa gástrica antral, comparando-se os achados endoscópicos e histológicos, que foram classificados segundo o Sistema Sidney. Os 92 exames analisados englobaram 35 homens e 57 mulheres, com idade variando entre 15 e 84 anos. A indicação mais frequente foi epigastralgia. RESULTADOS: Dentre os 92 exames analisados, o diagnóstico histológico de gastrite antral apareceu em 75 exames, sendo que 59 laudos endoscópicos continham o diagnóstico de gastrite antral e 33 laudos endoscópicos foram normais. O coeficiente kappa foi 0,212 com P<0,05, mostrando que não há concordância significativa entre os achados endoscópicos e o diagnóstico histológico de gastrite antral. CONCLUSÃO: Concluímos que a histologia representa o método padrão-ouro para o diagnóstico de gastrite antral, e que na prática clínica diária, biópsias devem ser sempre realizadas, independente dos achados endoscópicos.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Gastroscopy/methods , Gastritis/pathology , Gastritis/diagnostic imaging , Biopsy , Reproducibility of Results , Helicobacter pylori/isolation & purification , Helicobacter Infections/pathology , Helicobacter Infections/diagnostic imaging , Gastric Mucosa/pathology , Middle Aged
12.
Braz. j. microbiol ; 49(3): 544-551, July-Sept. 2018. tab, graf
Article in English | LILACS | ID: biblio-951820

ABSTRACT

Abstract The epidemiology of Helicobacter pylori resistance to antibiotics is poorly documented in Africa and especially in Algeria. The aim of our study was to determine the antibiotic resistance rates, as well as its possible relationship with VacA and CagA virulence markers of isolates from Algerian patients. One hundred and fifty one H. pylori isolate were obtained between 2012 and 2015 from 200 patients with upper abdominal pain. Antimicrobial susceptibility testing was performed for amoxicillin, clarithromycin, metronidazole, ciprofloxacin, rifampicin and tetracycline. Molecular identification of H. pylori and the detection of vacA and cagA genes were performed using specific primers. We found that H. pylori was present in 83.5% of collected biopsies, 54.9% of the samples were cagA positive, 49.67% were vacA s1m1, 18.30% were vacA s1m2 and 25.49% were vacA s2m2. Isolates were characterized by no resistance to amoxicillin (0%), tetracycline (0%), rifampicin (0%), a high rate of resistance to metronidazole (61.1%) and a lower rate of resistance to clarithromycin (22.8%) and ciprofloxacin (16.8%). No statically significant relationship was found between vagA and cagA genotypes and antibiotic resistance results (p > 0.5) except for the metronidazole, which had relation with the presence of cagA genotype (p = 0.001).


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Bacterial Proteins/genetics , Helicobacter pylori/drug effects , Helicobacter Infections/microbiology , Drug Resistance, Bacterial , Anti-Bacterial Agents/pharmacology , Antigens, Bacterial/genetics , Helicobacter pylori/isolation & purification , Helicobacter pylori/genetics , Helicobacter pylori/metabolism , Clarithromycin/pharmacology , Algeria , Amoxicillin/pharmacology
13.
Arq. gastroenterol ; 55(2): 122-127, Apr.-June 2018. tab, graf
Article in English | LILACS | ID: biblio-950513

ABSTRACT

ABSTRACT BACKGROUND: The association between infection with Helicobacter pylori and different gastroduodenal diseases is related to bacterial, host and environmental factors. Studies have demonstrated an association between the genetic diversity of H. pylori, especially in the vacA and cagA genes, and the development of digestive diseases such as peptic ulcer and gastric cancer. In addition, the nature of the host inflammatory response may explain these different manifestations of infection caused by this microorganism. In this respect, host factors that regulate the immune and inflammatory responses involving the functional interaction of H. pylori infection with different components of the immune system, particularly T cells, in gastroduodenal diseases still need further investigation. OBJECTIVE: To characterize the immune response, including immunity induced by infection with H. pylori, especially virulent strains (vacA alleles and cagA gene), by analyzing the cytokine profile and T-cell population present in gastroduodenal diseases in a Brazilian population. METHODS: In a prospective study, gastric biopsies were collected from 554 patients with different gastroduodenal diseases for histological analysis and for the determination of bacterial genotype and cytokine production (IL-4, IL-10, IFN-γ and IL-12) by ELISA. RESULTS: The predominant genotype of the H. pylori strains isolated from the patients studied was s1m1cagA+, which was more common among patients with gastric ulcer, duodenal ulcer and gastric cancer. A significant association was observed between the s1m1cagA+ genotype and a higher degree of inflammation, higher neutrophil activity and the development of intestinal metaplasia. The gastric concentrations of IFN-γ and IL-12 were significantly higher in patients infected with H. pylori than in uninfected individuals. Higher levels of these cytokines were detected in patients with gastric ulcer and cancer, while the levels of IL-4 and IL-10 in the gastric mucosa were lower in these patients. In addition, IFN-γ and IL-12 concentrations in gastric biopsies were higher in patients infected with the virulent s1m1cagA+ genotype. In contrast, IL-4 and IL-10 levels were higher in tissue infected with s2m2cagA in gastric biopsies. CONCLUSION: Our study shows that the interaction between the type of infectious strain and the Th1 immune response can influence and perpetuate gastric inflammation, and thus contributes to the development of the different clinical manifestations of H. pylori infection.


RESUMO CONTEXTO: A associação da infecção por Helicobacter pylori com diferentes doenças gastroduodenais pode estar associada a fatores bacterianos, do hospedeiro e do ambiente. Nesse contexto, estudos têm demonstrado que a diversidade genética do H. pylori, sobretudo nos genes vacA e cagA, está associada ao desenvolvimento de doenças gastroduodenais como a úlcera péptica e o câncer gástrico. Além disso, a natureza da resposta inflamatória do hospedeiro pode explicar essas diferentes manifestações da infecção por esse microrganismo. Portanto, fatores do hospedeiro que regulam as respostas imunológica e inflamatória, envolvendo a interação funcional da infecção por H. pylori com diferentes membros do compartimento imunológico, especialmente respostas imunes de células T nas doenças gastroduodenais, ainda precisam ser melhor estudados. OBJETIVO: Caracterizar a resposta imune, incluindo imunidade induzida por infecção pelo H. pylori, especialmente com cepas virulentas de H. pylori (alelos vacA e gene cagA), através da análise do perfil de citocinas e da caracterização da população de células T presentes em doenças gastroduodenais em nossa população. MÉTODOS: Em um estudo prospectivo, foram coletadas biópsias gástricas de 554 pacientes portadores das diferentes doenças gastroduodenais. Nas amostras biológicas destes pacientes foi realizada a determinação do genótipo bacteriano e a detecção das citocinas IL-4, IL-10, INF-γ e IL-12 através do método Elisa. Foram obtidas biópsias gástricas para avaliação histológica. RESULTADOS: Observamos que o genótipo predominante nas cepas de H. pylori isoladas dos pacientes estudados foi s1m1cagA positivo, sendo mais frequentes entre os pacientes com úlcera gástrica, úlcera duodenal e câncer gástrico. Houve associação significativa das cepas com o genótipo s1m1cagA positivo com maior grau de inflamação, atividade neutrofílica e desenvolvimento de metaplasia intestinal. As concentrações gástricas de INF-γ e IL-12 foram significativamente mais elevadas em pacientes infectados pelo H. pylori do que nos não infectados. Foram detectados níveis mais elevados dessas citocinas nos portadores de úlcera e câncer gástrico, sendo que nesses pacientes foram observados níveis mais baixos de IL-4 e IL-10 na mucosa gástrica. Além disso, as concentrações de INF-γ e IL-12 em biópsias gástricas, foram mais elevadas nos pacientes portadores das cepas bacterianas virulentas s1m1cagA+. Contrariamente, os níveis de IL-4 e IL-10 foram maiores em tecido infectado por cepas s2m2cagA. Pacientes com maior grau de inflamação, de atividade neutrofílica e presença de metaplasia intestinal, apresentaram níveis mais elevados de INF-γ e IL-12 e uma concentração mais baixa de IL-4 e IL-10 nas biópsias gástricas. CONCLUSÃO: Nosso estudo demonstra que a interação entre o tipo de cepa infectante e resposta imunológica com perfil Th1, podem influenciar e perpetuar a inflamação gástrica contribuindo para o desenvolvimento de diferentes manifestações clínicas na infecção pelo H. pylori.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Aged , Aged, 80 and over , Young Adult , Stomach Neoplasms/immunology , Helicobacter pylori/genetics , Helicobacter Infections/immunology , Duodenal Ulcer/immunology , Gastric Mucosa/immunology , Gastritis/immunology , Stomach Neoplasms/microbiology , Bacterial Proteins/genetics , DNA, Bacterial , Polymerase Chain Reaction , Prospective Studies , Cytokines/biosynthesis , Helicobacter pylori/isolation & purification , Helicobacter Infections/microbiology , Duodenal Ulcer/microbiology , Gastric Mucosa/microbiology , Gastric Mucosa/pathology , Gastritis/microbiology , Genes, Bacterial/immunology , Genotype , Middle Aged , Antigens, Bacterial/genetics
14.
J. pediatr. (Rio J.) ; 94(3): 273-278, May-June 2018. tab
Article in English | LILACS | ID: biblio-954620

ABSTRACT

Abstract Objective Several studies have been performed concerning pathologies of the stomach and esophagus in the pediatric age group. However, there have been very few studies of duodenal pathologies in children. The authors aimed to examine the clinical, endoscopic, and histopathological characteristics, as well as the etiology of duodenal pathologies in children. Method Patients aged between 1 and 17 years undergoing esophagogastroduodenoscopy during two years at this unit, were investigated retrospectively. Demographic, clinical, endoscopic data, and the presence of duodenal pathologies, gastritis, and esophagitis were recorded in all of the children. Results Out of 747 children who underwent endoscopy, duodenal pathology was observed in 226 (30.3%) patients. Pathology was also present in the esophagus in 31.6% of patients and in the stomach in 58.4%. The level of chronic diarrhea was higher in patients with duodenal pathology when compared with those without duodenal pathology (p = 0.002, OR: 3.91, 95% CI: 1.59-9.57). Helicobacter pylori infection was more common in patients with pathology in the duodenum (59.3%). Conclusion Duodenal pathology was detected in 30.3% of the present patients. A significantly higher level of chronic diarrhea was observed in subjects with duodenal pathologies compared to those with no such pathology. The rate of Helicobacter pylori infection was considerably higher than that in previous studies. In addition, there is a weak correlation between endoscopic appearance and histology of duodenitis.


Resumo Objetivo Foram feitos vários estudos com relação a patologias do estômago e esôfago na faixa etária pediátrica. Contudo, poucos estudos das patologias duodenais em crianças. Visamos a examinar as características clínicas, endoscópicas e histopatológicas, juntamente com a etiologia, das patologias duodenais em crianças. Método Foram investigados retrospectivamente pacientes entre 1 e 17 anos submetidos a esofagogastroduodenoscopia durante dois anos em nossa unidade. Os dados demográficos, clínicos e endoscópicos e a presença de patologias duodenais, gastrite e esofagite foram registrados com relação a todas as crianças. Resultados Das 747 crianças submetidas a endoscopia, 226 (30,3%) apresentaram patologia duodenal. A patologia também esteve presente no esôfago de 31,6% dos pacientes e no estômago de 58,4%. O nível de diarreia crônica foi maior nos pacientes com patologia duodenal, em comparação com os pacientes sem patologia duodenal (p = 0,002, RC: 3,91, IC de 95%: 1,59-9,57). Infecção por Helicobacter pylori foi mais comum em pacientes com patologia no duodeno (59,3%). Conclusão Foi detectada patologia duodenal em 30,3% de nossos pacientes. Um nível significativamente maior de diarreia crônica foi observado em indivíduos com patologias duodenais, em comparação aos sem patologia. A infecção por Helicobacter pylori esteve presente consideravelmente maior do que em estudos anteriores. Além disso, há uma fraca correlação entre a imagem endoscópica e a histologia de duodenite.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Helicobacter Infections/diagnosis , Duodenal Diseases/diagnosis , Biopsy , Retrospective Studies , Endoscopy, Digestive System , Helicobacter pylori/isolation & purification , Duodenal Diseases/classification , Duodenal Diseases/microbiology
15.
Rev. méd. Chile ; 146(5): 555-561, mayo 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-961431

ABSTRACT

Background: Helicobacter pylori (HP) is the most widespread chronic human infection worldwide and the most important pathogenic factor of gastric cancer. The calculated prevalence at the Clinical Hospital of the University of Chile from 2002 to 2005 was 44.9%. Aim: To determine the current prevalence of HP in patients undergoing an upper gastrointestinal endoscopy (UGI) and analyze its distribution according to age and endoscopic findings. Material and Methods: We reviewed 3.433 UGI performed during the year 2015, selecting those in which rapid urease test (RUT) was done. A positive RUT or a positive gastric biopsy (GB) were considered as HP infection. Results: RUT was done in 1862 UGI (55%) performed in patients aged 51 ± 17 years, (66% women). In 23% of these endoscopies, the RUT was positive. A GB was obtained 43% of endoscopies and 30% were positive for HP. In 105 patients the RUT was negative and the GB positive (rendering a 19.5% false negative rate). HP was detected by RUT and GB in 29% of endoscopies. The highest prevalence of infection (38.1%) was found between 40 and 49 years. HP infection had odds ratio of 4.24 for nodular gastropathy, 2.63 for gastric ulcer and 2.14 for duodenal ulcer (p < 0.05). Conclusions: HP prevalence in our center decreased significantly from 44.9% to 28.9% in 11 years. False negative RUT results may bias this finding. The use of proton pump inhibitors and antimicrobials that can interfere with the detection of HP should be registered to properly analyze the results of the RUT.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Helicobacter pylori/isolation & purification , Helicobacter Infections/diagnosis , Gastrointestinal Diseases/microbiology , Biopsy , Chile/epidemiology , Prevalence , Cross-Sectional Studies , Retrospective Studies , Endoscopy, Gastrointestinal , Helicobacter Infections/epidemiology , Age Distribution , Gastrointestinal Diseases/diagnosis , Gastrointestinal Diseases/epidemiology
16.
Rev. Soc. Bras. Med. Trop ; 51(2): 183-189, Mar.-Apr. 2018. tab
Article in English | LILACS | ID: biblio-897069

ABSTRACT

Abstract INTRODUCTION: Helicobacter pylori, a water contaminant, is the primary pathogenic agent associated with gastric diseases in humans. Exposure to H. pylori is more likely higher in developing countries. This study aimed to evaluate the risk factors associated with H. pylori infection in patients undergoing endoscopy to validate the cause of dyspeptic symptoms in an urban population in northeast Brazil and to compare the urease test and polymerase chain reaction assay results with the histopathological findings. METHODS: We evaluated 200 of 759 individuals with dyspeptic complaints from Campina Grande, State of Paraiba, northeast Brazil. Patients underwent endoscopy, followed by gastric biopsies. Logistic regression analysis was performed to adjust for confounders and to determine significant risk factors of dyspeptic disorders. RESULTS: Women accounted for 72.5% (145/200) of the participants. Approximately 59.8% (120/200) of the samples tested positive for H. pylori based on histological examinations. The specificity of polymerase chain reaction assay was higher than that of the urease test (77% vs. 64%, p=0.034). City drinking water [odds ratio (OR): 2.6; 95% confidence interval (CI): 1.3-5.21; p=0.004] and smoking (OR: 4.0; 95% CI: 1.13-14.5; p=0.031) were the risk factors of H. pylori infection. Belching was the most common symptom associated with H. pylori infection (p=0.05). CONCLUSIONS: The increased risk of H. pylori infection associated with non-treated water consumption indicates the need for improvements in public water treatment and better sanitary conditions because these can be a source of not only H. pylori infections but also other water-borne pathogen infections.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Helicobacter pylori/isolation & purification , Helicobacter Infections/diagnosis , Duodenal Ulcer/microbiology , Dyspepsia/microbiology , Gastritis/microbiology , Socioeconomic Factors , Urban Population , Polymerase Chain Reaction , Risk Factors , Endoscopy, Gastrointestinal , Helicobacter pylori/genetics , Sensitivity and Specificity , Duodenal Ulcer/diagnosis , Dyspepsia/diagnosis , Gastritis/diagnosis , Middle Aged
17.
Clinics ; 73: e16553, 2018. tab, graf
Article in English | LILACS | ID: biblio-952792

ABSTRACT

OBJECTIVE: The 13C-urea breath test is the main non-invasive test for the diagnosis of Helicobacter pylori infection. The availability of this test throughout the country is limited, mainly due to the difficulty in obtaining the labeled isotope from abroad. Recently, researchers from the Nuclear Energy Center in Agriculture at the University of São Paulo (CENA/USP) succeeded in synthesizing 13C-enriched urea for Helicobacter pylori diagnosis. The aim of the study was to compare the performance of the 13C-urea breath test using 13C-urea acquired abroad with that of a test using 13C-urea synthesized in Brazil. METHOD: Sixty-four dyspeptic patients participated in the study (24 men and 40 women). Initially, the patients performed the 13C-urea breath test using the imported substrate (Euriso-Top, France). Seven to fourteen days later, all the patients repeated the test using the Brazilian substrate. The samples from both examinations were processed in an infrared isotope analyzer (IRIS, Wagner Analisen Technik, Germany), and all delta over baseline (DOB) [%] values above four were considered positive results. RESULTS: Twenty-seven patients (42%) exhibited negative results for Helicobacter pylori infection, and thirty-seven patients (58%) exhibited positive results when tested using the foreign substrate (gold standard). There was a 100% concordance regarding the presence or absence of infection when the gold standard results were compared with those obtained using the Brazilian substrate. CONCLUSIONS: Similar performance in the diagnosis of Helicobacter pylori infection was demonstrated when using the 13C-urea breath test with the Brazilian 13C-urea substrate and the test with the substrate produced abroad. This validation represents an important step toward increasing the availability of the 13C-urea breath test throughout the country, which will have a positive influence on the management of Helicobacter pylori infection.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Urea/analysis , Urea/chemical synthesis , Carbon Isotopes/analysis , Carbon Isotopes/chemical synthesis , Helicobacter Infections/diagnosis , Reference Values , Time Factors , Brazil , Breath Tests/methods , Reproducibility of Results , Helicobacter pylori/isolation & purification , Statistics, Nonparametric
18.
Arq. gastroenterol ; 54(3): 217-221, July-Sept. 2017. tab, graf
Article in English | LILACS | ID: biblio-888207

ABSTRACT

ABSTRACT BACKGROUND: The clinical outcome of Helicobacter pylori infection has been associated with virulence factors. The presence of these factors is useful as molecular markers in the identification of the high risk for developing severe gastric pathologies. OBJECTIVE: To correlate the presence of virulence markers cagA and bab2A of H. pylori in oral and gastric biopsy samples. METHODS: An observational, prospective, descriptive, and cross-sectional study was carried out between September 2011 and September 2012. Patients suffering dyspepsia with indication for upper gastrointestinal video endoscopy who attended the Gastroenterology Service of the Hospital Dr. Julio C. Perrando were included. Epidemiological investigation was completed. To detect the bacteria and their virulence genes, samples of saliva, dental plaque and gastric biopsy were taken and processed by PCR. RESULTS: Sixty-one patients were selected for this study (30 women and 31 men). H. pylori was detected in 31 gastric biopsies and 31 oral samples. Significant difference between oral and gastric samples was found in cagA genotype. Agreement between oral and gastric genotypes was found in 38.7% of samples from the same patient. CONCLUSION: This study is the first in provide information about the genotypes of the Argentinean Northeast H. pylori strains. Despite the high prevalence of H. pylori infection, the most of patients had less virulent genotypes in oral cavity and gastric tissue. The cagA / babA2 combination was not frequent in the samples studied. There was not a statistical correlation between the virulence genes and gastroduodenal or oral diseases. Although in some patients the same genotype was found both in oral and gastric samples, it cannot be ensure that they corresponding to the same strain because a DNA sequencing was not performed.


RESUMO CONTEXTO: O resultado clínico da infecção por Helicobacter pylori tem sido associado com fatores de virulência. A presença desses fatores como marcadores moleculares é útil na identificação do risco elevado para o desenvolvimento de graves patologias gástricas. OBJETIVOS: Correlacionar a presença de marcadores de virulência cagA e bab2A do H. pylori em amostras de biópsias gástricas e orais. MÉTODOS: Um estudo observacional, prospectivo, descritivo e transversal foi realizado entre setembro de 2011 e setembro de 2012. Foram incluídos pacientes com sintomas de dispepsia com indicação de endoscopia gastrointestinal que compareceram ao Serviço de Gastroenterologia do Hospital Dr. Julio C. Perrando . Investigação epidemiológica foi concluída. Para detectar a bactéria e seus genes de virulência, amostras de saliva, placa dentária e biópsia gástrica foram tomadas e processadas pelo PCR. RESULTADOS: Sessenta e um pacientes foram selecionados para este estudo (30 mulheres e 31 homens). H. pylori foi detectado em 31 biópsias gástricas e 31 amostras orais. Foi encontrada diferença significativa entre as amostras orais e gástricas no genótipo cagA . A ocorrência simultânea entre genótipos orais e gástricos do mesmo paciente foi encontrada em 38,7% das amostras. CONCLUSÃO: Este é o primeiro estudo a fornecer informações sobre os genótipos das cepas do H. pylori no Nordeste Argentino. Apesar da alta prevalência da infecção pelo H. pylori , a maioria dos pacientes tinha genótipos menos virulentos na cavidade oral e tecido gástrico. A combinação cagA / babA2 não foi frequente nas amostras estudadas. Não houve correlação estatística entre os genes de virulência e doenças gastroduodenais ou orais. Embora em alguns pacientes o mesmo genótipo tenha sido encontrado tanto nas amostras orais quanto gástricas, não se pode garantir que correspondam à mesma variação, pois um sequenciamento de DNA não foi realizado.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Aged , Aged, 80 and over , Young Adult , Bacterial Proteins/genetics , Helicobacter pylori/pathogenicity , Helicobacter Infections/microbiology , Adhesins, Bacterial/genetics , Gastric Mucosa/microbiology , Mouth/microbiology , Antigens, Bacterial/genetics , Biopsy , Biomarkers/analysis , Cross-Sectional Studies , Prospective Studies , Helicobacter pylori/isolation & purification , Virulence Factors/genetics , Genotype , Middle Aged
19.
Braz. j. microbiol ; 48(2): 218-224, April.-June 2017. tab, graf
Article in English | LILACS | ID: biblio-839380

ABSTRACT

Abstract The severity of Helicobacter pylori-related disease is correlated with the presence and integrity of a cag pathogenicity island (cagPAI). cagPAI genotype may have a modifying effect on the pathogenic potential of the infecting strain. After analyzing the sequences of cagPAI genes, some strains with the East Asian-type cagPAI genes were selected for further analysis to examine the association between the diversity of the cagPAI genes and the virulence of H. pylori. The results showed that gastric mucosal inflammatory cell infiltration was significantly higher in patients with East Asian-type cagPAI genes H. pylori strain compared with mosaicism cagPAI genes H. pylori strain (p < 0.05). H. pylori strains with the East Asian-type cagPAI genes were closely associated with IL-8 secretion in vitro and in vivo compared with H. pylori strains with the mosaicism cagPAI genes (p < 0.01). H. pylori strains with East Asian-type cagPAI genes are able to strongly translocate CagA to host cells. These results suggest that H. pylori strains with East Asian-type cagPAI genes are more virulent than the strains of cagPAI gene/genes that are Western type.


Subject(s)
Humans , Helicobacter pylori/classification , Helicobacter pylori/genetics , Helicobacter Infections/microbiology , Helicobacter Infections/pathology , Genomic Islands , Genotype , Phylogeny , Virulence , Cluster Analysis , Helicobacter pylori/isolation & purification , Virulence Factors/genetics , Gastric Mucosa/pathology , Histocytochemistry , Microscopy
20.
Säo Paulo med. j ; 135(2): 140-145, Mar.-Apr. 2017. tab
Article in English | LILACS | ID: biblio-846288

ABSTRACT

ABSTRACT CONTEXT AND OBJECTIVE: The prevalence of Helicobacter pylori infection is unevenly distributed among different populations. The aim here was to evaluate the factors associated with Helicobacter pylori infection among children up to five years of age living in a high-risk community. DESIGN AND SETTING: Cross-sectional study in an indigenous community of Guarani Mbya ethnicity, Tekoa Ytu and Tekoa Pyau villages, Jaraguá district, city of São Paulo (SP), Brazil. METHODS: 74 children aged 0.4 to 4.9 years (mean 2.9 ± 1.3 years; median 3.1), and 145 family members (86 siblings, 43 mothers and 16 fathers) were evaluated for Helicobacter pylori infection using the validated 13C-urea breath test. Clinical and demographic data were collected. RESULTS: The prevalence was 8.3% among children aged 1-2 years and reached 64.3% among those aged 4-5 years (P = 0.018; overall 31.1%). The prevalence was 76.7% among siblings and 89.8% among parents. There was a negative association with previous use of antibiotics in multivariate analysis adjusted for age (odds ratio, OR: 0.07; 95% confidence interval, CI: 0.01 to 0.66; P = 0.02). The prevalence was higher among males (OR: 1.55), and was associated with maternal infection (OR: 1.81), infection of both parents (OR: 1.5), vomiting (OR: 1.28), intestinal parasitosis (OR: 2.25), previous hospitalization (OR: 0.69) and breastfeeding (OR: 1.87). CONCLUSIONS: The prevalence was high among subjects older than three years of age, thus suggesting that the incidence of infection was higher over the first three years of life. Previous use of antibiotics was inversely associated with current Helicobacter pylori infection.


RESUMO CONTEXTO E OBJETIVO: A prevalência da infecção pelo Helicobacter pylori é desigualmente distribuída entre diferentes populações. O objetivo foi avaliar fatores associados à infecção pelo Helicobacter pylori em crianças de até cinco anos de idade morando numa comunidade de alto risco. TIPO DE ESTUDO E LOCAL: Estudo transversal na comunidade indígena da etnia Guarani Mbya das aldeias Tekoa Ytu e Tekoa Pyau do distrito de Jaraguá da cidade de São Paulo (SP), Brasil. MÉTODOS: 74 crianças de 0,4 a 4,9 anos (média 2,9 ± 1,3 anos; mediana 3,1), e 145 familiares (86 irmãos, 43 mães e 16 pais) foram avaliadas quanto à infecção pelo Helicobacter pylori com o teste respiratório com ureia 13C validado. Dados clínicos e demográficos foram coletados. RESULTADOS: Prevalência foi 8,3% entre 1-2 anos, atingindo 64,3% entre 4-5 anos (P = 0,018; 31,1% globalmente). Em irmãos, foi 76,7% e 89,8% nos pais. Observou-se associação negativa com uso prévio de antibiótico em análise multivariada ajustada para idade (odds ratio, OR: 0,07; intervalo de confiança, IC: 95%: 0,01-0,66; P = 0,02). A prevalência foi maior no sexo masculino (OR: 1,55), e foi associada a infecção materna (OR: 1,81), infecção de ambos os pais (OR: 1,5), vômitos (OR: 1,28), parasitose intestinal (OR: 2,25), hospitalização prévia (OR: 0,69) e aleitamento materno (OR: 1,87). CONCLUSÕES: A prevalência foi alta entre os indivíduos com mais de três anos de idade, o que sugere incidência maior nos três primeiros anos de vida. Uso prévio de antibióticos foi inversamente associado a infecção atual por Helicobacter pylori.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Indians, South American , Helicobacter pylori/isolation & purification , Helicobacter Infections/epidemiology , Brazil/epidemiology , Prevalence , Cross-Sectional Studies , Risk Factors , Age Factors
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