Seroepidemiology of hepatitis E virus infection in pigs in Durango State, Mexico.

No information about hepatitis E virus (HEV) infection in pigs in the northern Mexican state of Durango exists. We determined the seroprevalence and correlates of anti-HEV IgG antibodies in pigs in Durango, Mexico. Through a cross-sectional study, we studied 427 pigs raised in backyards (n = 328), or slaughtered (n = 99) in Durango. Sera of pigs were analyzed for anti-HEV IgG antibodies using a commercially available enzyme-linked immunoassay. Antibodies to HEV were found in 193 (45.2%) of the 427 pigs studied. A significantly higher seroprevalence was observed in slaughtered pigs (79.8%) than in backyard pigs (34.8%). Bivariate analysis showed that HEV seropositivity was associated with age, sex, breed, climate, altitude, mean annual temperature, mean annual rainfall, and farm raising. Logistic regression analysis showed that HEV seropositivity was associated with the origin (Sonora State) of pigs (OR=6.51; 95%CI: 3.74-11.32; P < 0.001), and mean annual rainfall (≤600 mm) (OR=1.78; 95%CI: 1.01-3.15; P = 0.04). A high seroprevalence of HEV infection in pigs slaughtered for human consumption in Durango City was found. This is the first report of an association between HEV seropositivity in pigs and climatic factors. Infection factors found may help for the optimal planning of preventive measures against HEV infection.

Hepatitis E virus exposure in pregnant women in rural Durango, Mexico.

BACKGROUND AND AIM: Hepatitis E virus (HEV) infection represents a risk for mortality in pregnant women. The seroepidemiology of HEV infection in rural pregnant women in the Americas is largely unknown. The aim of the study was to determine the seroepidemiology of anti-HEV IgG antibodies in rural pregnant women in Durango, Mexico. MATERIALS AND METHODS: The presence of anti-HEV IgG antibodies was determined in 439 pregnant women in rural Durango, Mexico using an enzyme-linked immunoassay. Seroprevalence association with socio-demographic, clinical and behavioral characteristics of the women was also investigated. RESULTS: Twenty five (5.7%; 95% CI: 3.88-8.27) of the 439 women (mean age: 24.53 ± 6.1 years) had anti-HEV antibodies. Multivariate analysis showed that HEV seropositivity was associated with increasing age (OR = 1.11; 95% CI: 1.03-1.20; P = 0.004), consumption of unpasteurized cow milk (OR = 5.37; 95% CI: 1.17-24.63; P = 0.03), and overcrowding at home (OR = 2.36; 95% CI: 1.13-4.92; P = 0.02). In contrast, the variables educational level, occupation, socio-economic status, foreign travel, consumption of untreated water and raw or undercooked meat, and raising animals did not show associations with HEV seropositivity. Exposure to HEV was associated with the number of deliveries but not with the number of cesarean sections or miscarriages. CONCLUSIONS: This is the first report of seroprevalence and contributing factors for HEV infection in rural pregnant women in the Americas, and of an association of the consumption of unpasteurized cow milk with HEV exposure. Results of this study should be useful for designing optimal preventive measures against HEV infection. vg

TNF-α Polymorphisms and Maternal Depression in a Mexican Mestizo Population.

BACKGROUND: Depressive disorders are common during pregnancy. There is compelling evidence that the inflammatory response system is important in the pathophysiology of depression. Higher concentrations of proinflammatory cytokines including tumor necrosis factor-alpha (TNF-α) in depressed subjects have been described. Because several polymorphisms in the TNF-α promoter region are known to affect its gene expression, the aim of this study was determine whether TNF-α - 857C/T, -308G/A, and -238G/A polymorphisms confer susceptibility to depression during pregnancy in a Mexican mestizo population. METHODS: This case-control study involved 153 depressed pregnant women and 177 controls. Polymorphisms were genotyped using real-time PCR. Odds ratios (OR) and 95% confidence intervals adjusted by age, body mass index, number of pregnancies, months of pregnancy and number of abortions were used to estimate risk. RESULTS: The -857CT genotype was found to increase the risk for depression (OR= 1.73, 95% CI= 1.06-2.82). In contrast, the -238GA genotype reduced the risk (OR= 0.33, 95% CI= 0.14-0.72). The - 308G/A polymorphism was not associated with risk for depression. Finally, the C857-G308-A238 haplotype was associated with a decreased risk of depression (OR= 0.35, 95% CI= 0.15-0.82). CONCLUSION: Our results show for the first time an association between TNF-α -857C/T and -238G/A polymorphisms and prenatal depression in Mexican mestizo population.

[Gastropathy caused by non-steroidal anti-inflammatory agents and its association with Helicobacter pylori]. / Gastropatía por antiinflamatorios no esteroideos y su asociación con Helicobacter pylori.

BACKGROUND: Upper gastrointestinal bleeding that is related with older patients and NSAIDs use. The frequency of peptic ulcer bleeding varies of 15% to 30% of cases. OBJECTIVE: To determine the gastropathy features of patients who receive nonsteroidal anti-inflammatory drug, and its relation with Helicobacter pylori (Hp). METHODS: Men and women with GU or DU with or without haemorrhage, were included into two groups, NSAIDs users and non users. We determined the incidence rate of peptic ulcer and the frequencies of risk factors as tobacco use, previous peptic ulcer or haemorrhage, concomitant disease presence and its association with Hp infection. RESULTS: We included 434 (67.5%) patients that used NSAIDs and 209 (32.5%) non NSAIDs users control subjects. The average was 62.5 +/- 17.2 years and 49.5 +/- 19.4 years respectively. The annual incidence rate of peptic ulcer in NSAIDs users was 17.5%. Gastrointestinal bleeding was more frequent in NSAIDs users and its relations with Hp infection (23.5%) was smaller than patients without NSAIDs user (47.7%) (OR 0.39 p = 0.0000). CONCLUSIONS: The GU was highly frequent in the older people who using NSAIDs. The Hp infection shows lower incidence of gastrointestinal bleeding NSAIDs users.

[Analysis of liver biopsy experience in a regional hospital]. / Análisis de la experiencia en biopsia hepática en un hospital regional.

UNLABELLED: Hepatic biopsy is a safe procedure. Its findings contribute to precise diagnoses and in selecting or modifying the treatment of some patients with liver diseases. AIM: To analyze indications, findings and complications of hepatic biopsy. MATERIAL AND METHODS: Retrospective study of patients with hepatic disease in which a hepatic biopsy was obtained. Information pertaining to clinical characteristics, biopsy indications and its results were collected. All tissue samples were stained with hematoxylin-eosin, Masson and Perl. The analysis was performed by descriptive statistics, chi 2 test and the Fisher exact test. RESULTS: There were 54.6% were women and 45.4% were men. In 361 patients the major diagnoses were: Hepatic cirrhosis 19.1%, hepatic metastases 16.3%, chronic hepatitis 11.6%, alcoholic hepatitis 11.1% and nonalcoholic steatohepatitis 9.7%. In 66.2% of the biopsies were preformed meanwhile patients were in the Hospital. The procedure was ultrasound-assisted in 76%. There were major complications in 1.4%. CONCLUSION: The hepatic disease is more common in the woman and the pathologic results show that the etiology of liver diseases in our hospital are similar to reports of third level hospitals in Mexico, its major complications were fewer.

Erradicación del Helicobacter pylori en úlcera péptica y gastritis crónica. Ensayo clínico aleatorio / Eradication of Helicobacter pylori in pepetic ulcer and chronic gastritis. Randomized clinical study

Antecedentes. El helicobacter pylori (Hp) se presenta en más del 80 por ciento de los casos con enfermedad ácido péptica. Su erradicación requiere antimicrobianos cuya efectividad puede alcanzar 90 por ciento o más, según el esquema utilizado. Objetivo. Comparar la eficacia de erradicación del Hp en úlcera péptica y gastritis crónica con dos esquemas de tratamiento. Material y métodos. Se incluyeron pacientes mayores de 20 años, con enfermedad ácido péptica y biopsia positiva con Hp. Se investigaron antecedentes de úlcera y hemorragia, ingestión de AINE's, tabaco y alcohol. Fueron sometidos a endoscopia superior con biopsia de antro inicial y postratamiento para documentar erradicación. Se administraron dos esquemas de tratamiento: GI: subsalicilato de bismuto-tetraciclina-metronidazol-ranitidina, GII subsalicilato de bismuto amoxicilina-metronidazol-ranitidina. Análisis estadístico. Chi2 y análisis multivariado. Resultados. Se incluyeron 118 pacientes, 52 por ciento del sexo femenino, 48 por ciento del masculino con edad promedio de 47 ñ 16 años. El 79 por ciento de los casos tuvieron historia previa de úlcera y hemorragia, 62 por ciento, ingestión de AINE's 49 por ciento y tabaquismo 30 por ciento al momento de su diagnóstico. El 90 por ciento presentó dolor, melena 47 por ciento y 24 por ciento hematemesis. La erradicación de Hp fue de 70 por ciento para ambos esquemas (pNS), persistió la ulcera gástrica y duodenal en 23 por ciento y la ingestión de AINE's se asoció a pobre cicatrización ulcerosa y falla de erradicación (p<0.05). Conclusiones. Se obtuvo erradicación del Hp en 70 por ciento sin diferencia entre ambos grupos. Falla en cicatrización ulcerosa en 23 por ciento de los casos y los AINE's se asociaron a probre cicatrización y erradicación de Hp (p<0.05)

Diagnóstico retrospectivo de un brote de triquinosis en el Estado de Durango / Retrospective diagnosis of a trichinosis authebreake in the State of Durango

Al observar los sintomas de los enfermos de la epidemia de triquinosis de Nuevo Ideal se recordó que ocho meses antes ya se habían observado en el Hospital del IMSS en Durango casos semejantes, procedentes de una ciudad llamada Santiago Papasquiaro. La biopsia de músculo realizada en abril de 1982 a una de estas pacientes demonstró que era triquinosis lo que habían padecido. A propósito de esos casos se comentan sus síntomas y especialmente las manifestaciones oculares enfermedad