Helicobacter pylori cagA and vacA genotypes as predictors of progression of gastric preneoplastic lesions: a long-term follow-up in a high-risk area in Spain.

OBJECTIVES: There are no established predictive markers of progression of gastric preneoplastic lesions. The aim of this study was to analyze the relationship between Helicobacter pylori cagA and vacA genotypes and progression of gastric preneoplastic lesions. METHODS: This was a follow-up study that carried out in a province of Spain with a high risk of gastric cancer. A total of 312 patients who underwent upper endoscopy with gastric biopsy in 1988-1994 with diagnoses of normal mucosa, non-atrophic gastritis (NAG), non-metaplastic multifocal atrophic gastritis (MAG), and complete or incomplete intestinal metaplasia (IM), and who accepted to undergo a new biopsy during 2005-2007 or had an end point during follow-up, were included in this study. Detection and characterization of H. pylori cagA and vacA genotypes was performed directly in baseline paraffin-embedded gastric biopsy specimens by PCR followed by reverse hybridization onto a line probe assay. Inter- and intra-observer variability of histological diagnosis was assessed. Analysis was done using unconditional logistic regression. RESULTS: The mean age of patients was 48.5 years (45% males) and the mean of follow-up was 12.8 years. H. pylori strains harboring cagA, vacA s1, and vacA m1 genotypes were more frequently found in patients with more advanced gastric preneoplastic lesions. Infection with cagA-positive, vacA s1, and vacA m1 strains was associated with progression of gastric preneoplastic lesions (multivariate odds ratio (OR)=2.28, 95% confidence interval (CI) 1.13-4.58; OR=2.90, 95% CI 1.38-6.13; and OR=3.38, 95% CI 1.34-8.53, respectively). Infection with strains that are simultaneously cagA positive and vacA s1/m1 was associated with progression of gastric precancerous lesions with an OR of 4.80 (95% CI 1.71-13.5) in relation to those infected with cagA-negative/vacA s2/m2 strains. CONCLUSIONS: H. pylori genotyping may be useful for the identification of patients at high risk of progression of gastric preneoplastic lesions and who need more intensive surveillance.

Triple therapy with clarithromycin, amoxicillin and omeprazole for Helicobacter pylori eradication in children and adolescents.

BACKGROUND: Helicobacter pylori infection presents high prevalence in developing countries, but there are few pediatric assays evaluating antimicrobial treatment. OBJECTIVE: The aim of this study was to investigate Helicobacter pylori eradication rate using a short regimen (7 and 10 days) of triple therapy with clarithromycin, amoxicillin and omeprazole. PATIENTS AND METHODS: Twenty-five Hp positive patients who presented severe epigastralgia, were submitted to antimicrobial treatment with amoxicillin (50 mg/kg/day--maximum dose 1 g bid), clarithromycin (30 mg/kg/day--maximum dose 500 mg bid) and omeprazole (0.6 mg/kg/day--maximum dose 20 mg bid) during 7 or 10 days. After 2 months, clinical symptoms were evaluated and gastric biopsies were taken to test Hp eradication. RESULTS: Overall eradication rate was achieved in 16/25 patients (64%--IC(95% = 45-83%), in 11/15 (73%--IC(95%) = 51-95%) patients who used 10 days therapy course and in 5/10 (50%--IC(95%) = 19-81%) who used 7 days therapy course. Eradication drugs were well accepted and adverse effects were reported in two patients (8%). CONCLUSIONS: This triple therapy regimen had moderate efficacy (64%). The data suggests that 10 days therapy course achieves better eradication rate (73%) than 7 days course (50%) to treat Hp infection in our population.

Determination of sulphamethizole in the presence of nitrofurantoine by derivative spectrophotometry and ratio spectra derivative.

Two methods for determining sulphamethizol in the presence of nitrofurantoine in mixtures by first-derivative spectrophotometry and by the first derivative of the ratio spectra are described. The procedures do not require any separation step. In the first method the measurements are obtained in the zero-crossing wavelengths and the calibration graphs were linear up to 32 mug/ml of sulphamethizole at 251 and 278.5 nm. In the second method, the calibration graphs were linear up to 43 mug/ml by measuring at the maximum (263 nm), at the minimum (244 nm) and peak to peak. The methods were applied for determining sulphamethizole in a pharmaceutical product containing nitrofurantoine.

[Symptomatic pericardial effusions in childhood]. / Derrames pericárdicos sintomáticos en la edad pediátrica.

We present the clinical data and the management of twelve patients with symptomatic pericardial effusion (PE). The etiology of PE was: Chronic renal failure, viral infection, cardiac surgery, juvenile rheumatoid arthritis and chronic myelocytic leukemia. Four cases were diagnosed as idiophatic. PE in childhood is usually asymptomatic. When symptoms are present they are non-specific and don't help to know the size of the effusion; therefore, it's necessary to practice an echocardiography to demostrate the presence of PE. The hemodynamic findings permit to diferentiate patients with and without cardiac tamponade. The treatment of first choice is aspirin. In patients with cardiac tamponade the treatment should be pericardiocentesis.

[Congenital long QT-interval syndrome]. / Síndrome del intervalo QT largo congénito.

Authors report one pediatric patient with prolonged QT-interval syndrome. Importance of this syndrome is based on the possibility of syncopal episodes, due to serious arrhythmias, and sudden death. Therapeutics protocols and prophylactic treatment's indications. They are reviewed conclude that familial study is necessary in congenital type and that better therapeutical results are achieved with propranolol than with others drugs.

[Congenital unilateral pulmonary hypoplasia]. / Hipoplasia pulmonar unilateral congénita.

Authors report twelve patients who presented unilateral diminished lung volume on chest x-ray and analyze ECG, bronchography, lung scan and angiography performed in this patients. Based on these data and following classification proposed by CURRARINO they divide patients in groups: 1) Simple lung hypoplasia, seven cases, four of these were of the left side. 2) Absence of one pulmonary artery, two cases. 3) Scimitar syndrome, three cases. Eleven patients have remained free of significant symptoms. Authors believe that diagnostic work-up of a patient with unilateral diminished lung volume on chest x-ray should depend on clinical symptoms and possibility of surgical treatment. Therapeutic approach will depend on clinical and anatomic findings.

A simple method for the extraction of polysaccharide B from Brucella cells for use in the radial immunodiffusion test diagnosis of bovine brucellosis.

In order to extract the polysaccharide B of brucella used in Radial Immunodiffusion test (RID) for detection of infected cattle, a quick, simple and safe method is proposed. It consists of using phenol killed cells of B. melitensis 16 M known to produce polysaccharide B. After autoclaving brucella cells resuspended in saline, the cells are separated by centrifugation and the polysaccharide B is obtained by two successive ethanol precipitations of the supernatant. Comparison of the results of RID tests carried out with the polysaccharide extract of B. melitensis 16 M (rapid method) and 231 sera of infected cattle shows the validity of this method of preparation. Differences in yield (1.5% for the second precipitate against 0.5% for the polysaccharide-reference and in optimum dose used the reaction (10 microgram against 200 microgram) show that as many as 60 times more RID tests can be made with the polysaccharide obtained by rapid method.