Comparación de dos esquemas de tratamiento para erradicar helicobacter pylori / Comparison of 2 treatment schemes to erradicate helicobacter pylori

Introduction: Anti secretory drugs, antimicrobials and bismuth salts are used with variable success to erradicate helicobacter pylori. Aim: To assess the effectiveness and rates of reinfection of 2 therapeutic modalities H pylori infection in adult patients with duodenal ulcer or non ulcer dyspepsia. Methods: during upper gastrointestinal endoscopy, 5 antral and 2 fundic biopsies were obtained and sent for microbiological and anatomopathological study. Patients infected with Helicobacter pylori were randomly assigned to receive during 2 weeks omeprazole 20 mg od plus amoxicillin 500 mg tid (group A) or bismuth subsalicylate 260 mg bid, metronidazole 250 mg tid and amoxicillin 500 mg tid (group B). A new endoscopy with antral and fundic biopsies was performed to all patients four weeks after discontinuing treatment and six months later to those in whom H pylori was eradicated. Results: 80 patients (40 in each treatment group) completed the treatment and follow up. H pylori was eradicated in 22 patients of group A (55 percent) and 28 of group B (70 percent). Minor adverse effects were reported by 5 patients in group A (12 percent) and 11 in group B (27.5 percent). Six months later, reinfection was documented in 12 patients of group A and 8 of group B (54 percent and 30 percent of those with successful treatment respectively). Ten of 25 patients with duodenal ulcer had reinfections, but there was only one ulcer relapse. Conclusion: These 2 treatment modalities have similar results

Aislamiento bacteriano en lactantes hospitalizados por diarrea aguda / Bacterial isolation in infants hospitalized by acute diarrhea

Se estudió la presencia de agentes bacterianos en las deposiciones de 156 lactantes hospitalizados por diarrea aguda en el servicio de pediatría del Hospital San Juan de Dios, Servicio de Salud Metropolitano Occidente, mediante muestras únicas obtenidas por sonda rectal. Se aislaron agentes patogenos en 115 casos (73,7%), de los cuales 87 correspondieron a bacterias (55,7% del total de pacientes y 75,6% de las identificaciones de presunto agente causal). Las bacterias aisladas con más frecuencia fueron las ECEP (65,5%) con predominio de los serogrupos 0111, 0119 y 055, seguidos por ECET (18,4%), Campylobacter yeyuni (13,8%), Salmonella (9,2%) y Shigella (6,9%). ECEI y Aeromonas hydrophila fueron, cada una, aisladas en un caso (1,1%). No se aisló Yersinia enterocolitica. La mayoría de los niños (92%) eran menores de un año y 83% eran lactantes eutróricos o desnutridos grado I. Los leucocitos fecales estaban aumentados en 41,4% de los casos con aislamiento de bacterias en las deposiciones y en 17,4% de los restantes, en 83% de los lactantes en los que se aisló Shigella, en 50% de ECEP y Salmonella y 25% de Campylobacter