RESUMO
In Thailand, gastric cancer incidence is considerably low despite the high prevalence of Helicobacter pylori infection. We investigated the prevalence of H. pylori infection and the genotypes of cagA by using 179 stool specimens obtained from asymptomatic Thai individuals. In this study, the prevalence of H. pylori infection was 43.6%, and the detection rate of cagA-positive strains was 43.5%. In addition, the proportion of the highly virulent East-Asian type of cagA was 7.2%. These results indicate that the low prevalence of cagA-positive H. pylori strain as well as the low prevalence of East-Asian genotype cagA-positive strains may contribute to the low gastric cancer incidence.
Assuntos
Portador Sadio/epidemiologia , Portador Sadio/microbiologia , Infecções por Helicobacter/epidemiologia , Infecções por Helicobacter/microbiologia , Helicobacter pylori/patogenicidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Antígenos de Bactérias/genética , Proteínas de Bactérias/genética , Fezes/microbiologia , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Tailândia/epidemiologia , Fatores de Virulência/genéticaRESUMO
CONTEXT: Pancreatic pseudocysts located in the mediastinum are rare. Symptomatic mediastinal pseudocysts can present with dysphagia, dyspnea, airway obstruction and/or cardiac tamponade. Generally, the standard approaches are surgery and external drainage. Recently, there have been many reports of successful endoscopic drainage mainly using a transpapillary technique. However, there have only been a handful of reports involving successful transmural drainage of mediastinal pseudocysts. CASE REPORT: We report a case of a mediastinal pseudocyst developed after a severe blunt trauma. The patient presented with orthopnea and dysphagia. Multidetector computerized scanning of the abdomen and thorax revealed a thin, cystic, low-attenuation mass in the posterior mediastinum associated with compression of the esophagus and significant pericardial effusion. An endoscopic retrograde pancreatogram demonstrated a normal size pancreatic duct with an extravasation of contrast from the tail of the pancreas into the cyst. Ultimately, the cyst was successfully drained trough gastric fundus. CONCLUSION: Symptomatic mediastinal pseudocysts communicating with the pericardial sac can be successfully drained using a transmural endoscopic approach without the need for surgery or external drainage.
