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

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

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

[Adenocarcinoma of the adrenal gland. An accidental finding. Report of a case and review of the literature]. / Adenocarcinoma de la glándula suprarrenal. Un hallazgo accidental. Reporte de un caso y revisión de la literatura.

Carcinoma of the adrenal gland is a very unusual entity with a very poor prognosis. Even though the great advances in imaging during the last few years, the possibility of an early diagnosis of these tumors has not been reached. In a high percentage of cases, the diagnosis was made as incidentalomas while doing some complementary tests. A multidisciplinary team is necessary for the diagnosis and management of this pathology. We report a case of non functional adrenal cortex carcinoma, it's diagnosis, management and evolution.

[Giardiasis duodenitis: is the endoscopic diagnosis possible?]. / Duodenitis giardiásica: es factible el diagnóstico endoscópico?

60 patients (p) with ages ranging between 19 and 73 (32 females and 28 males) were selected and randomized for a prospective study about he confirmation of endoscopic wounds reported like giardiasic duodenitis: a nodular whitish puncture over the mucous with a focal or diffuse pattern over. We tested the correlation between the endoscopic findings and the results of histopathology and fecal tests. A duodenoscopy until the second portion was made with an Olympus GIF-Q equipment, 2 biopsies were taken from the duodenal bulb and from the second portion. 45 (p) exhibited a typical aspect before mentioned. In this group we found the protozoa in the biopsies of 35 (p) (77.78%). The fecal test were positive for 22 of these (p) (48.88%) and negative for 23 (51.12%). 15 (p) had a normal duodenoscopy; 13 of these (p) had a negative biopsy (86.66%) and only two cases (13.33%) resulted in a positive biopsy for giardia. The results for the fecal tests were negative in 93.34% (p). The most common symptoms were: upper-abdominal pain (67.50), acidity (62.50%), pyrosis (25%) diarrhea (10%) and constipation (10%). The results of our study confirm that endoscopic lesions of duodenum observed as a whitish nodular puncture, over the mucous with a focal or diffuse pattern were compatible with a duodenitis caused by giardia lamblia. It was confirmed in the majority of cases with biopsy and in almost 50% of fecal test performed.