Nuestra experiencia en el manejo diagnóstico-terapéutico a corto plazo del paciente con displasia anal / Our experience in the short-term diagnostic-therapeutic management of the patient with anal dysplasia

Introducción: La neoplasia intraepitelial anal (NIA) es una lesión premaligna del carcinoma escamoso anal. Los varones VIH que tienen sexo con varones, es la población de riesgo más afectada. La citología y anuscopia son los métodos mejor aceptados para su diagnóstico, aunque es controvertido qué pacientes deben completarlo con una biopsia. Tampoco está bien establecido qué pacientes deben someterse a tratamiento y cuál es el mejor. Con este estudio, queremos exponer nuestra experiencia en el manejo diagnóstico-terapéutico de la NIA a corto plazo. Métodos: Estudio observacional retrospectivo de pacientes con riesgo de NIA con una citología anal alterada a los que se les realizó una anuscopia de alta resolución con biopsia. Tras la confirmación histológica de displasia iniciaron tratamiento con ácido tricloroacético. Se comprobó su efectividad con una citología posterior. Se analizaron las variables demográficas de la muestra y los resultados de las pruebas diagnósticas y de tratamiento. Resultados: La mayoría eran varones VIH positivos (104/115) y el 50% mantenían relaciones sexuales con otros varones. Se incluyeron 115 pacientes con citología anal alterada, de los cuales el 92% presentaron displasia en la biopsia. El 97% con atipia de significado incierto en la citología presentaron displasia histológicamente. El 60% de los pacientes normalizó la citología tras el tratamiento. Conclusión: Se debe considerar de forma sistemática la detección precoz de la NIA en poblaciones de riesgo conocidas. Cualquier anormalidad citológica debe ser biopsiada. El ácido tricloroacético puede ser un tratamiento efectivo consiguiendo un alto porcentaje de regresión, aunque actualmente la información con la que contamos es de bajo nivel de evidencia. (AU)

Introduction: Anal intraepithelial neoplasia (AIN) is a premalignant lesion of anal squamous cell carcinoma. HIV-positive males who have sex with males, are the most affected at-risk population. Cytology and anuscopy are the best accepted methods for its diagnosis, although it is controversial which patients should complete it with a biopsy. Neither which patients should undergo treatment nor which is the best treatment is not well established. With this study, we would like to present our experience in the diagnostic-therapeutic management of AIN in the short term. Methods: Retrospective observational study of patients at risk of AIN with altered anal cytology who underwent high-resolution anuscopy with biopsy. After histological confirmation of dysplasia, they started treatment with trichloroacetic acid. Its effectiveness was verified by subsequent cytology. The demographic variables of the sample and the results of both diagnostic and treatment tests were analyzed. Results: The majority were HIV-positive males (104/115) and 50% had sexual relations with other men. We included 115 patients with altered anal cytology, of whom 92% had dysplasia on biopsy. 97% with atypia of uncertain significance on cytology had histological dysplasia. Cytology normalized after treatment in 60% of patients. Conclusion: Early detection of AIN should be routinely considered in known at-risk populations. Any cytological abnormality should be biopsied. Tricholoroacetic acid can be an effective treatment achieving a high percentage of regression, although currently, the information we have is of low level of evidence. (AU)

Our experience in the short-term diagnostic-therapeutic management of the patient with anal dysplasia.

INTRODUCTION: Anal intraepithelial neoplasia (AIN) is a premalignant lesion of anal squamous cell carcinoma. HIV-positive males who have sex with males, are the most affected at-risk population. Cytology and anuscopy are the best accepted methods for its diagnosis, although it is controversial which patients should complete it with a biopsy. Neither which patients should undergo treatment nor which is the best treatment is not well established. With this study, we would like to present our experience in the diagnostic-therapeutic management of AIN in the short term. METHODS: Retrospective observational study of patients at risk of AIN with altered anal cytology who underwent high-resolution anuscopy with biopsy. After histological confirmation of dysplasia, they started treatment with trichloroacetic acid. Its effectiveness was verified by subsequent cytology. The demographic variables of the sample and the results of both diagnostic and treatment tests were analyzed. RESULTS: The majority were HIV-positive males (104/115) and 50% had sexual relations with other men. We included 115 patients with altered anal cytology, of whom 92% had dysplasia on biopsy. 97% with atypia of uncertain significance on cytology had histological dysplasia. Cytology normalized after treatment in 60% of patients. CONCLUSION: Early detection of AIN should be routinely considered in known at-risk populations. Any cytological abnormality should be biopsied. Tricholoroacetic acid can be an effective treatment achieving a high percentage of regression, although currently, the information we have is of low level of evidence.

Phytoremediation of potentially toxic elements using constructed wetlands in coastal areas with a mining influence.

This paper proposes the use of wetlands as a phytoremediation strategy for areas of mining and maritime influence in the southeast of Spain. Potentially toxic elements (PTEs) tolerant and salinity-resistant macrophytes (Phragmites australis, Juncus effusus and Iris pseudacorus) have been used. The experiment is carried out in an aerobic artificial wetland using representative sediments affected by mining activities in the study area. Selected species were placed in pots containing substrates made with different mixtures of topsoil and/or peat, mining residues (black or yellow sand). After six months, rhizosphere, root and aerial parts were collected. A transfer study of As, Pb, Zn and Cu is performed, determining contents in rhizosphere and plant (aerial and underground part). From these data, the TF and BCF were calculated for each plant in 15 different substrates. The work is complemented by an initial study of scanning electron microscopy (SEM-EDX) of plants. The obtained results indicate a tolerance of the metallophytes to these PTEs, which may favour the obtaining of a naturalized habitat that acts as an effective protective barrier to the ecosystem, that is easy to maintain and that avoid the risk of transfer to the trophic chain. The use of these species can be a complement to the chemical stabilization proposed for the whole area and carried out in experimental plots. Because they are perennial plants, it is necessary to continue with the experiments and obtain results in a longer period of time that allows to evaluate yield and stabilization.

Characterization and mobilization of toxic metals from electrolytic zinc waste.

The natural and forced mobilization of lead, cadmium and arsenic in zinc hydrometallurgy waste is studied with the purpose of establishing potentially environmentally damaging levels and associated risks in uncontrolled situations. Differential X-Ray diffraction is used to study, in simulated environmental situations, the relevant role played by several mineralogical and amorphous phases. The study of potential mobility shows that all the samples considered are susceptible of releasing a significant amount of potentially toxic elements (PTEs) depending of the particular environmental conditions. Two situations can be considered the most problematic: the natural mobilization of the released cadmium and zinc as a result of rain, and a change in the redox conditions caused by an anoxic environment (flooding and/or incorporation of organic matter). The presence of massive quantities of soluble salts increases the hazard potential of these residues, mobilizing the PTEs and creating a potential carcinogenic risk caused by a possible oral intake for both children and adults.

Opinion survey on proposals for improving code stroke in Murcia Health District V, 2014. / Encuesta de opinión sobre propuestas de mejora del código ictus en el Área V de la Región de Murcia, 2014.

INTRODUCTION: Stroke is a time-dependent neurological disease. Health District V in the Murcia Health System has certain demographic and geographical characteristics that make it necessary to create specific improvement strategies to ensure proper functioning of code stroke (CS). The study objectives were to assess local professionals' opinions about code stroke activation and procedure, and to share these suggestions with the regional multidisciplinary group for code stroke. SUBJECTS AND METHOD: This cross-sectional and descriptive study used the Delphi technique to develop a questionnaire for doctors and nurses working at all care levels in Area V. An anonymous electronic survey was sent to 154 professionals. The analysis was performed using the SWOT method (Strengths, Weaknesses, Opportunities, and Threats). RESULTS: Researchers collected 51 questionnaires. The main proposals were providing training, promoting communication with the neurologist, overcoming physical distances, using diagnostic imaging tests, motivating professionals, and raising awareness in the general population. CONCLUSIONS: Most of the interventions proposed by the participants have been listed in published literature. These improvement proposals were forwarded to the Regional Code Stroke Improvement Group.

Impact of acid mine drainages on surficial waters of an abandoned mining site.

Weathering of sulphide minerals produces a great variety of efflorescences of soluble sulphate salts. These minerals play an important role for environmental pollution, since they can be either a sink or a source for acidity and trace elements. This paper aims to characterise surface waters affected by mining activities in the Sierra Minera of Cartagena-La Union (SE, Spain). Water samples were analysed for trace metals (Zn, Cd, Pb, Cu, As and Fe), major ions (Na(+), K(+), Ca(2+) and Mg(2+)) and anions (F(-), Cl(-), NO3 (-), CO3 (2-), SO4 (2-)) concentrations and were submitted to an "evaporation-precipitation" experiment that consisted in identifying the salts resulting from the evaporation of the water aliquots sampled onsite. Mineralogy of the salts was studied using X-ray diffraction and compared with the results of calculations using VISUAL MINTEQ. The study area is heavily polluted as a result of historical mining and processing activities that has produced large amount of wastes characterised by a high trace elements content, acidic pH and containing minerals resulting from the supergene alteration of the raw materials. The mineralogical study of the efflorescences obtained from waters shows that magnesium, zinc, iron and aluminium sulphates predominate in the acid mine drainage precipitates. Minerals of the hexahydrite group have been quantified together with minerals of the rozenite group, alunogen and other phases such as coquimbite and copiapite. Calcium sulphates correspond exclusively to gypsum. In a semiarid climate, such as that of the study area, these minerals contribute to understand the response of the system to episodic rainfall events. MINTEQ model could be used for the analysis of waters affected by mining activities but simulation of evaporation gives more realistic results considering that MINTEQ does not consider soluble hydrated salts.

Exposure of the gilthead seabream (Sparus aurata) to sediments contaminated with heavy metals down-regulates the gene expression of stress biomarkers.

Heavy metals incidence in the aquatic environment and its accumulation in fish are under constant review. Gilthead seabream (Sparus aurata) specimens were exposed for two weeks to sediments highly concentrated in metals, collected at the Portman Bay (Murcia, Spain). The metals bioaccumulation was tested in liver, muscle and skin. The potential of the sediment exposure to induce variation of the stress biomarkers genes was conducted in liver and skin. Results revealed that sediments were highly contaminated with metals. However, following 2 weeks exposure to the sediments, Cd accumulates only in liver. Interestingly, the expression of the genes mta, hsp 70 and hsp 90 were significantly down-regulated in skin. Nevertheless, cyp1a1 gene was up-regulated only in liver. Results uphold that the stress response magnitude was organ-dependent and the skin was the most responsive tissue to metal stress conditions. These results suggest that skin should be considered as target organ for biomarkers analysis in fishes.

Comparison of Two Types of Liquid Biopsies in Patients With Hepatocellular Carcinoma Awaiting Orthotopic Liver Transplantation.

INTRODUCTION: Orthotopic liver transplantation (OLT) is considered one of the few curative treatments available for early stages of hepatocellular carcinoma (HCC). It has been shown that more than 10% of transplanted individuals suffer relapse during the first year after surgery and most of them die because of the tumor. The circulating tumor cells (CTCs) are the main source of recurrences as they disseminate from a primary or metastatic tumor lesion through peripheral blood. We aimed to determine the concentration of CTCs in peripheral blood in these patients by 2 different approaches: the CellSearch and the IsoFlux systems to assess their applicability to this disease monitoring. PATIENTS AND METHODS: A comparative study was conducted in 21 patients with HCC eligible for liver transplantation according to the Milan criteria, whose peripheral blood was processed by the CellSearch and the IsoFlux systems. RESULTS: CTCs were isolated in 1 of the 21 patients (4.7%) by the CellSearch system and in 19 of the 21 patients (90.5%) by the IsoFlux method. The comparison of both methods using Bland-Altman plot shows that there is not consistency in the determination of CTCs in our patients, finding a proportional bias between them. CONCLUSION: The results obtained by both CTCs isolation systems are not interchangeable nor transferable. The CellSearch system does not seem to be the ideal approach for studying CTCs in patients with HCC. The IsoFlux system displays greater sensitivity in the identification of CTCs and might become an important tool in patient management.

Accumulation, histopathology and immunotoxicological effects of waterborne cadmium on gilthead seabream (Sparus aurata).

Studies in fish have demonstrated that Cd-exposure produce skeletal deformities and alterations in tissue morphology, enzyme activities, stress response, ion regulation and immune response. In the present work, gilthead seabream (Sparus aurata) specimens were exposed to waterborne Cd (5 µM CdCl2 or 1 mg L(-1)) for 2, 10 or 30 days. Organo-somatic changes, Cd accumulation, liver histology and humoral and cellular immune responses were determined. Results showed that exposure of seabream specimens to Cd induced no alterations on spleen and liver organo-somatic indexes whilst produced progressive deleterious morphological alterations in liver and exocrine pancreas that correlated with the hepatic Cd-accumulation. Regarding the immunotoxicological potential, strikingly, Cd-exposure produced a reduction in the serum complement activity and leucocyte respiratory burst to a significant extent after 10 and 30 days whilst the serum peroxidase activity and leucocyte phagocytosis were increased at different sampling times. On the other hand, serum IgM levels and leucocyte peroxidase activity resulted unaltered. The present results seem to indicate that seabream exposed to Cd in the present conditions suffer toxicity.

Immunotoxicological effects of inorganic arsenic on gilthead seabream (Sparus aurata L.).

Arsenic (As) has been associated with multitude of animal and human health problems; however, its impact on host immune system has not been extensively investigated. In fish, there are very few works on the potential risks or problems associated to the presence of arsenic. In the present study we have evaluated the effects of exposure (30 days) to sub-lethal concentrations of arsenic (5 µM As2O3) in the teleost fish gilthead seabream (Sparus aurata), with special emphasis in the innate immune response. The arsenic concentration was determined using atomic fluorescence spectrometry (AFS) in liver and muscle of exposed fish showing As accumulation in the liver after 30 days of exposure. The hepatosomatic index was increased at significant extent after 10 days but returned to control values after 30 days of exposure. Histological alterations in the liver were observed including hypertrophy, vacuolization and cell-death processes. Focusing on the immunological response, the humoral immune parameters (seric IgM, complement and peroxidase activities) were no affected to a statistically significant extent. Regarding the cellular innate parameters, head-kidney leucocyte peroxidase, respiratory burst and phagocytic activities were significantly increased after 10 days of exposition compared to the control fish. Overall, As-exposure in the seabream affects the immune system. How this might interfere with fish biology, aquaculture management or human consumers warrants further investigations. This paper describes, for the first time, the immunotoxicological effects of arsenic exposure in the gilthead seabream, which is a species with the largest production in Mediterranean aquaculture.

Post-transplant increase in soluble human leukocyte antigen-G associated with non-severe cardiac allograft vasculopathy.

Cardiac allograft vasculopathy (CAV) is the single most important long-term limitation to heart transplantation. This study aimed to assess the value of monitoring soluble human leukocyte antigen-G (sHLA-G) during the first year post-transplantation to predict the severity of CAV, in 21 out of 77 heart recipients assessed by intravascular ultrasound (IVUS). Serum sHLA-G concentration increased after transplant in recipients free of severe CAV, but decreased in recipients suffering from severe CAV, significant differences between these two groups were found 6 to 12 months post-transplantation. The optimal value of the change in post-transplant sHLA-G for identifying severe CAV was ≥0.062%, which maximized sensitivity (80%) and specificity (100%). Importantly, increases in post-transplant sHLA-G were inversely associated with severe CAV, but directly associated with human cytomegalovirus reactivation. In addition, recipients presenting non-severe CAV or an increased sHLA-G post-transplantation, showed higher numbers of CD8(+)CD28(-) T cells and a down-modulation of CD28 on CD4(+) lymphocytes, which typically identifies CD8(+) regulatory T cells and anergic/tolerogenic T helper cells, respectively. In conclusion, quantification of sHLA-G might offer a complementary non-invasive method for identifying recipients at risk of more severe CAV and who might benefit from earlier preventive therapies, although these results need to be confirmed in larger series.

Factores de morbimortalidad postoperatoria tras cirugía laparoscópica por cáncer de colon en pacientes octogenarios / Postoperative morbidity and mortality factors after laparoscopic resection for colon cancer in octogenarians

Introducción: Dado el aumento del diagnóstico de cáncer de colon y el acceso al tratamiento en pacientes mayores de 80 años, nuestro objetivo es valorar si el abordaje laparoscópico sigue aportando las ventajas demostradas en la recuperación postoperatoria, al tiempo que analizamos los factores que pueden influir en dichos resultados. Material y método Se han analizado retrospectivamente 593 pacientes, intervenidos de cáncer de colon por laparoscopia de forma electiva entre enero de 1999 y diciembre de 2010. Se dividieron en 33 grupos: A) menores de 70 años (n = 230), B) 70-79 años (n = 209), C) mayores o igual a 80 años (n=154). Las variables independientes: sexo, enfermedades asociadas, cirugía abdominal previa, índice de Karnosfky, índice de masa corporal (IMC), nivel de hemoglobina, proteínas y albúmina, CEA, grado de ASA, localización y estadificación tumoral. Variables dependientes perioperatoria: conversión, tiempo operatorio y pérdidas hemáticas; y postoperatorias: complicaciones locales y generales, requerimiento de unidad de cuidados intensivos, reintervenciones, estancia hospitalaria y éxitus. Resultados El grupo C presentó una mayor incidencia (p<0,001) de hipertensión arterial, diabetes mellitus, cardiopatía, neumopatía y ASA grado 3, así como valores inferiores de índice de Karnofsky, IMC, hemoglobina, albúmina y proteínas totales. Durante el postoperatorio se observó (p>0,001), mayor incidencia de complicaciones generales (respiratorias y urinarias), reintervenciones, ingresos en unidad de cuidados intensivos, éxitus y mayor estancia hospitalaria. Conclusión Aunque la cirugía laparoscópica ofrece ventajas a los pacientes mayores de 80 años con cáncer de colon, este grupo de pacientes presenta un mayor riesgo de complicaciones que la población más joven y, en consecuencia, debemos ser cuidadosos en su manejo (AU)

Introduction: Given the increase in the diagnosis in colon cancer and the access to treatment in patients over 80 years old, our aim is to assess whether laparoscopic surgery still has the demonstrated advantages in post-operative recovery, as well as to analyse the factors that may influence these results. Material and method: A retrospective analysis was made on a total of 593 patients subjected to elective laparoscopy surgery due to cancer of the colon between January 1999 and December 2010. They were divided into three age groups: A) less than 70 years (n = 230),B) 70-79 years (n = 209), C) 80 years or over (n = 154). The independent variables were: gender, concomitant diseases, previous abdominal surgery, Karnosfky index, BMI, level of, haemoglobin, proteins and albumin, CEA, and ASA grade, location (..) (AU)

CD28 and KIR2D receptors as sensors of the immune status in heart and liver transplantation.

Viral infections and cellular acute rejection (AR) condition immunosuppressive therapy and compromise the evolution of allografts. Immune monitoring can be useful for ascertaining rejection and for differentiating allo-reaction from activation induced by infections. This work analyzes the usefulness of monitoring the expression of CD28 and KIR2D receptors in peripheral blood T lymphocytes by flow cytometry, to ascertain the immune response in heart and liver transplant recipients. In both types of transplant, the up-regulation of CD28 in CD4(+) lymphocytes in the periods of greatest AR frequency indicates an effective allo-response, whereas the post-transplantation emergence of circulating CD8(+)CD28(-) and CD8(+)CD28(-)KIR2D(+) T cells correlates with better early clinical results. Cytomegalovirus (CMV) infection, but not hepatitis C virus (HCV) or other infections, abrogated both CD28 up-regulation and CD8(+)CD28(-)KIR2D(+) T-cell expansion. Our results show that monitoring the expression of CD28 and KIR2D receptors on T lymphocytes might be considered as sensors of the immune status of heart and liver recipients.

Ecotoxicological evaluation for the screening of areas polluted by mining activities.

The aim of this study was to evaluate the applicability of three bioassays representing multiple trophic levels, for the preliminary ecotoxicological screening of sediments from sites contaminated by mining activities. Of the bioassays used in this study, the ostracod test was the most responsive. Vibrio fischeri luminescence inhibition assay was less sensitive to the toxicants in the sediments than the phytotoxicity assays. The general trend observed was an increase in toxicity values measured by the bioassays with increasing metal mobilization in sediment samples. Therefore, the test battery can be used as a rapid and sensitive tool to evaluate the heavy metal contamination in sediments.

Organización de la actividad asistencial del fisioterapeuta en salas de Atención Primaria / Organization of care activity of the physiotherapist in primary care sites

Objetivo: conocer el tiempo dedicado a la actividad asistencial en salas de fisioterapia del Área de Gestión Sanitaria Norte de Almería. Métodos: estudio observacional descriptivo de la actividad asistencial realizada en tres salas de fisioterapia de las Zonas Básicas de Salud de Serón, Albox y Los Vélez durante el mes de febrero de 2006. Se cuantificó el tiempo dedicado a las distintas actividades asistenciales en dichas salas. Se diferenció por actividad asistencial efectiva (tratamiento individual, grupal y tratamiento domiciliario), actividades de formación y tareas de organización, según indica la Guía de Procedimientos de Fisioterapia en Atención Primaria. Se cuantificaron también otras actividades no incluidas en la cartera de servicios del fisioterapeuta. Resultados: del total del tiempo trabajado durante el mes de febrero en las tres Zonas Básicas de Salud (18 días), el mayor porcentaje correspondió a la actividad asistencial efectiva con un 86,37% de la jornada laboral (aproximadamente 6 horas diarias). Para actividades organizativas el porcentaje de tiempo dedicado diariamente fue del 6,89%. El tiempo dedicado a las actividades no incluidas en la cartera de servicios fue de 6,74%. Conclusiones: se ha encontrado que tanto las actividades realizadas por el fisioterapeuta como los tiempos empleados para las mismas no se corresponden en general con lo recomendado, siendo el tratamiento individual el que mayoritariamente ocupa la jornada laboral. Se dedica tiempo a actividades que no son propias del fisioterapeuta de Atención Primaria y que sería más conveniente utilizar en actividades formativas, de prevención y promoción de la salud(AU)

Objective: Know the time dedicated to care activity in the physiotherapy rooms of the North Health Care Management Area of Almeria.Methods: Observational, descriptive study of the care activity performed in threephysiotherapy sites of the Basic Health Zones of Seron, Albox and los Velez during themonth of February 2006. Time dedicated to the different care activities in said sites wasquantified. It was differentiated by real care activity (individual and group treatment andhome treatment), training activities and organization tasks as indicated by thePhysiotherapy Procedures Guidelines in Primary Care. Other activities not included inthe list of physiotherapeutic services were also quantified.Results: The greatest percentage of time worked during the month of February in thethree Basic Health Zones (18 days) corresponded to real care activity, this accounting for86.37% of the work day (approximately 6 hours daily). The percentage of time dedicated toorganizational activities daily was 6.89%. Time dedicated to activities not included in thelist of services was 6.74%.Conclusions: It was found that both the activities performed by the physiotherapist andthe times used for them do not correspond in general with that recommended, individualtreatment being that which mostly occupies the work day. Time is dedicated to activitiesthat are not characteristic of the primary care physiotherapist and that could be betterused in training activities, prevention activities and health promotion activities(AU)

[Role of the Helicobacter pylori in the aetiology of acute appendicitis. Preliminary studies]. / Implicación del Helicobacter pylori en la etiopatogenia de la apendicitis aguda. Estudios preliminares.

Helicobacter pylori (H. pylori) has been found in the upper gastrointestinal tract. It is incriminated as aetiological factor in various pathological conditions. This study was designed to determine whether H. pylori plays a role in the pathogenesis of acute appendicitis. H.pylori was investigated in 40 patients divided in 2 groups. A: patients with abdominal pain and B: patients with acute appendicitis, confirmed by pathology studies. The Ag H.pylori was investigated in the faeces of both groups. In the group B, besides, appendix samples were tested for culture for H. pylori. Confirmation was made by PCR (Polymerase Chain Reaction) analysis. Statistical analysis was made. The positivity for H. pylori infection in the faeces was found in Group A in 15% of the patients and in the group B in 35%. In the group B, besides, the culture of the appendix cecal was positive in 71.4%. Though was observed difference between both groups, this one was not significant. It seems that H. pylori colonizes the appendix in small proportion and is unlikely to be associated in direct correlation with acute appendicitis. However, seropositive patients with acute inflammation are likely to suffer from purulent o gangrenous form.

Implicación del helicobacter pylori en la etiopatogenia de la apendicitis aguda. Estudios preliminares / Role of the helicobacter pylori in the aetiology of acute appendicitis. Preliminary studies

El Helicobacter pylori (HP) es el patógeno más común del tracto gastrointestinal en los seres humanos y se ha implicado en la etipatogénesis de muchas enfermedades digestivas. El objetivo de este trabajo es determinar si el Helicobacter pylori juega un papel en la patogénesis de la apendicitis aguda. Realizamos un estudio prospectivo en 40 pacientes divididos en 2 grupos, A: pacientes con dolor abdominal y B: pacientes intervenidos por apendicitis aguda, confirmada por anatomía patológica. En ambos grupos se investiga la presencia de HP. La detección del antígeno HP se realiza en las heces de los pacientes de ambos grupos y en el grupo B, además, en el apéndice cecal tras apendicectomía, mediante cultivo. En el grupo de pacientes con apendicitis aguda la detección del antigeno en heces (35%) fue superior a la del grupo A (15%), siendo positivo, además, el cultivo del apéndice cecal en el 71,4%. Aunque se observó diferencia entre ambos grupos, ésta no fue significativa. Nuestros resultados demuestran, por lo tanto, que aunque dicho bacilo puede colonizar el apéndice, no existe una relación significativa entre la apendicitis aguda y el HP. Sin embargo en los pacientes con cultivo positivo se ha observado mayor incidencia de apendicitis complicadas (purulentas o gangrenosas (AU)

Helicobacter pylori (H. pylori) has been found in the upper gastrointestinal tract. It is incriminated as aetiological factor in various pathological conditions.This study was designed to determine whether H. pylori plays a role in the pathogenesis of acute appendicitis. H.pylori was investigated in 40 patients divided in 2 groups. A: patients with abdominal pain and B: patients with acute appendicitis, confirmed by pathology studies. The Ag H.pylori was investigated in the faeces of both groups. In the group B, besides, appendix samples were tested for culture for H. pylori. Confirmation was made by PCR (Polymerase Chain Reaction) analysis. Statistical analysis was made. The positivity for H. pylori infection in the faeces was found in Group A in 15% of the patients and in the group B in 35%. In the group B, besides, the culture of the appendix cecal was positive in 71,4%. Though was observed difference between both groups, this one was not significant. It seems that H. pylori colonizes the appendix in small proportion and is unlikely to be associated in direct correlation with acute appendicitis. However, seropositive patients with acute inflammation are likely to suffer from purulent o gangrenous form (AU)