Estudio histopatológico de la presencia de bacterias tipo Helicobacter pylori en especímenes quirúrgicos con colecistitis crónica / Histopathological study of the presence of Helicobacter pylori-type bacteria in surgical specimens from patients with chronic cholecystitis

IntroducciónRecientemente se ha encontrado que especies de Helicobacter tienen alguna relación con ciertas enfermedades del árbol biliar; sin embargo, esto aún no está clara su vinculación y requiere mayores estudios. El propósito de este estudio fue determinar la presencia de bacterias tipo Helicobacter pylori (H. pylori) en pacientes con diagnóstico de colecistitis crónica, mediante el estudio histopatológico de los especímenes quirúrgicos de vesícula biliar.Materiales y métodosSe estudiaron anatomopatológicamente las piezas quirúrgicas de vesícula biliar de pacientes con diagnóstico de colecistitis crónica. Se establecieron las características macroscópicas de los especímenes. Los cortes histopatológicos se tiñeron con hematoxilina-eosina y con Giemsa.ResultadosDe los 68 pacientes a los que se practicó colecistectomía, 56 (81%) correspondieron a mujeres, y 12 (19%) hombres. La edad promedio fue 39,56+11,94 años. La presencia de bacterias tipo H. pylori fue de 6%.ConclusiónLos resultados de este estudio no permiten establecer que la presencia de las bacterias tipo H. pylori constituyan un factor importante en la etiología y/o patogenia de colecistitis crónica. En los pacientes con colecistitis crónica que reciben colecistectomía que se estudiaron en el presente trabajo, la etiología de la enfermedad crónica pudiese vincularse de manera más evidente con la presencia de formaciones calculosas (AU)

IntroductionHelicobacter species have recently been found to be associated with some diseases of the biliary tree but this relationship remains unclear and further studies are required. The aim of this study was to determine the presence of H. pylori-type bacteria in patients with a diagnosis of chronic cholecystitis through histopathological study of surgical gallbladder specimens.Materials and methodsSurgical gallbladder specimens from patients with a diagnosis of chronic cholecystitis were examined histopathologically. The macroscopic characteristics of the specimens were identified. Histopathological slices were stained with hematoxylin-eosin and Giemsa.ResultsOf the 68 patients who underwent cholecystectomy, 56 (81%) were women and 12 (19%) were men. The mean age was 39.56+11.94 years. H. pylori-type bacteria were found in 6%.ConclusionsThe results of this study do not allow us to conclude that the presence of H. pylori-type bacteria is a major factor in the etiology and/or pathogenesis of chronic cholecystitis. In patients with chronic cholecystitis undergoing cholecystectomy included in the present study, the etiology of the disease may be more closely linked with the presence of gallstones (AU)

[Histopathological study of the presence of Helicobacter pylori-type bacteria in surgical specimens from patients with chronic cholecystitis]. / Estudio histopatológico de la presencia de bacterias tipo Helicobacter pylori en especímenes quirúrgicos con colecistitis crónica.

INTRODUCTION: Helicobacter species have recently been found to be associated with some diseases of the biliary tree but this relationship remains unclear and further studies are required. The aim of this study was to determine the presence of H. pylori-type bacteria in patients with a diagnosis of chronic cholecystitis through histopathological study of surgical gallbladder specimens. MATERIALS AND METHODS: Surgical gallbladder specimens from patients with a diagnosis of chronic cholecystitis were examined histopathologically. The macroscopic characteristics of the specimens were identified. Histopathological slices were stained with hematoxylin-eosin and Giemsa. RESULTS: Of the 68 patients who underwent cholecystectomy, 56 (81%) were women and 12 (19%) were men. The mean age was 39.56+11.94 years. H. pylori-type bacteria were found in 6%. CONCLUSIONS: The results of this study do not allow us to conclude that the presence of H. pylori-type bacteria is a major factor in the etiology and/or pathogenesis of chronic cholecystitis. In patients with chronic cholecystitis undergoing cholecystectomy included in the present study, the etiology of the disease may be more closely linked with the presence of gallstones.

Correlación clínico-patológica en casos fatales de dengue en Maracaibo, Venezuela / Clinical and pathological correlation in fatal dengue cases found in Maracaibo, Venezuela

INTRODUCCIÓN: dada la importancia del dengue en América, es elemental conocer la causa de muerte de los infectados y evaluar los escasos estudios de necropsias. OBJETIVO: describir y analizar los hallazgos anatomopatológicos relevantes en casos fatales de dengue en un área endémica venezolana. MÉTODOS: se estudiaron 8 casos mortales con criterios clínico-epidemiológicos de dengue o comprobados mediante pruebas serológicas (o ambos), sometidos a necropsia clínica completa. Los tejidos se procesaron con técnicas histopatológicas habituales. RESULTADOS: todos los casos evidenciaron enfermedad pulmonar severa (daño alveolar difuso, edema pulmonar no cardiogénico, tromboembolismo, bronconeumonía, neumonitis, hemorragia intraalveolar); 6 mostraron derrame en cavidad pleural o abdominal, o en ambas. Necrosis hepática focal se presentó en 2 casos. La causa de muerte se relacionó con insuficiencia respiratoria en 6 casos secundaria a enfermedad pulmonar, 2 con choque hipovolémico y 1 desarrolló insuficiencia hepática. CONCLUSIONES: los casos mortales por dengue estudiados evidenciaron compromiso pulmonar severo relacionado con la muerte, a diferencia de lo reportado en otros estudios de necropsias en América. También desarrollaron afectación multiorganica, que en la mayoría de los casos condujo a la muerte no vinculada directamente a choque hipovolémico. Estos hallazgos de necropsias permitirían proyectar estrategias terapéuticas en pro de evitar la mortalidad(AU)

INTRODUCTION: given the importance of dengue in America, it is indispensable to know the cause of death of the infected people and to evaluate the few necropsy studies available. OBJECTIVE: to describe and to analyze the relevant clinical and pathological findings in fatal dengue cases of dengue in a Venezuelan endemic area. METHODS: eight fatal cases, according to clinical and epidemiological dengue criteria and/or confirmed by complete serological tests were studied after complete clinical necropsy. The tissues were processed by standard histopathological techniques. RESULTS: all these cases showed severe lung disease (diffuse alveolar damage, non cardiogenic pulmonary edema, thromboembolism, bronchopneumonia, pneumonitis, intralveolar hemorrhage). Six presented with pleural or abdominal effusion. Focal hepatic necrosis was found in two cases. The cause of death was related to respiratory failure in six cases secondary to lung disease; two with hypovolemic shock, and one developed liver failure. CONCLUSIONS: the studied dengue cases showed fatal severe pulmonary compromise leading to death, unlike those reported in other studies of autopsies in The Americas. They also developed multiple organ failure, which in most cases led to death not directly associated to hypovolemic shock. These findings in autopsies will allow designing therapeutic strategies to avoid mortality(AU)

Correlación clínico-patológica en casos fatales de dengue en Maracaibo, Venezuela / Clinical and pathological correlation in fatal dengue cases found in Maracaibo, Venezuela

INTRODUCCIÓN: dada la importancia del dengue en América, es elemental conocer la causa de muerte de los infectados y evaluar los escasos estudios de necropsias. OBJETIVO: describir y analizar los hallazgos anatomopatológicos relevantes en casos fatales de dengue en un área endémica venezolana. MÉTODOS: se estudiaron 8 casos mortales con criterios clínico-epidemiológicos de dengue o comprobados mediante pruebas serológicas (o ambos), sometidos a necropsia clínica completa. Los tejidos se procesaron con técnicas histopatológicas habituales. RESULTADOS: todos los casos evidenciaron enfermedad pulmonar severa (daño alveolar difuso, edema pulmonar no cardiogénico, tromboembolismo, bronconeumonía, neumonitis, hemorragia intraalveolar); 6 mostraron derrame en cavidad pleural o abdominal, o en ambas. Necrosis hepática focal se presentó en 2 casos. La causa de muerte se relacionó con insuficiencia respiratoria en 6 casos secundaria a enfermedad pulmonar, 2 con choque hipovolémico y 1 desarrolló insuficiencia hepática. CONCLUSIONES: los casos mortales por dengue estudiados evidenciaron compromiso pulmonar severo relacionado con la muerte, a diferencia de lo reportado en otros estudios de necropsias en América. También desarrollaron afectación multiorgánica, que en la mayoría de los casos condujo a la muerte no vinculada directamente a choque hipovolémico. Estos hallazgos de necropsias permitirían proyectar estrategias terapéuticas en pro de evitar la mortalidad.

INTRODUCTION: given the importance of dengue in America, it is indispensable to know the cause of death of the infected people and to evaluate the few necropsy studies available. OBJECTIVE: to describe and to analyze the relevant clinical and pathological findings in fatal dengue cases of dengue in a Venezuelan endemic area. METHODS: eight fatal cases, according to clinical and epidemiological dengue criteria and/or confirmed by complete serological tests were studied after complete clinical necropsy. The tissues were processed by standard histopathological techniques. RESULTS: all these cases showed severe lung disease (diffuse alveolar damage, non cardiogenic pulmonary edema, thromboembolism, bronchopneumonia, pneumonitis, intralveolar hemorrhage). Six presented with pleural or abdominal effusion. Focal hepatic necrosis was found in two cases. The cause of death was related to respiratory failure in six cases secondary to lung disease; two with hypovolemic shock, and one developed liver failure. CONCLUSIONS: the studied dengue cases showed fatal severe pulmonary compromise leading to death, unlike those reported in other studies of autopsies in The Americas. They also developed multiple organ failure, which in most cases led to death not directly associated to hypovolemic shock. These findings in autopsies will allow designing therapeutic strategies to avoid mortality.

[Clinical and pathological correlation in fatal dengue cases found in Maracaibo, Venezuela]. / Correlación clínico-patológica en casos fatales de dengue en Maracaibo, Venezuela.

INTRODUCTION: Given the importance of dengue in America, it is indispensable to know the cause of death of the infected people and to evaluate the few necropsy studies available. OBJECTIVE: To describe and to analyze the relevant clinical and pathological findings in fatal dengue cases of dengue in a Venezuelan endemic area. METHODS: Eight fatal cases, according to clinical and epidemiological dengue criteria and/or confirmed by complete serological tests were studied after complete clinical necropsy. The tissues were processed by standard histopathological techniques. RESULTS: All these cases showed severe lung disease (diffuse alveolar damage, non cardiogenic pulmonary edema, thromboembolism, bronchopneumonia, pneumonitis, intralveolar hemorrhage). Six presented with pleural or abdominal effusion. Focal hepatic necrosis was found in two cases. The cause of death was related to respiratory failure in six (6) cases secondary to lung disease; two with hypovolemic shock, and one developed liver failure. CONCLUSION: the studied dengue cases showed fatal severe pulmonary compromise leading to death, unlike those reported in other studies of autopsies in The Americas. They also developed multiple organ failure, which in most cases led to death not directly associated to hypovolemic shock. These findings in autopsies will allow designing therapeutic strategies to avoid mortality.

Prevalencia de tuberculosis pulmonar en pacientes indígenas y no indígenas del estado Zulia durante el periodo 1996-2005 / Prevalence of pulmonary tuberculosis in indigenous and non-indigenous patients in the state of Zulia 1996-2005

En la actualidad, Venezuela está ubicada en el grupo de países con moderada prevalencia de tuberculosis en la región de las Américas, con tasas estimadas entre 25 a 50 casos por 100.000 habitantes. Los altos índices de pobreza, desempleo, analfabetismo, necesidades básicas insatisfechas que ocurren en la población indígena contribuyen al aumento de los casos de tuberculosis en la población joven. El objetivo de esta investigación fue determinar la prevalencia de tuberculosis pulmonar en pacientes indígenas y no indígenas del Estado Zulia. El estudio fue de tipo descriptivo, retrospectivo, transversal y no experimental, con una población total de 889 casos durante el período comprendido entre 1996-2005. El grupo etario de mayor prevalencia fue el de 65 a 74 años (15,07 por ciento), el género masculino registró un 53,65 por ciento y el femenino 40,4 por ciento; se observó prevalencia de la población indígena (52,64 por ciento) en relación a la no indígena (47,36 por ciento), donde el grupo étnico Wayuu representó un 89,31 por ciento. Se determinó que la tuberculosis aumenta su prevalencia a través de los años, probablemente debido a la deficiencia en los métodos preventivos y adecuados programas de promoción de salud.

At present, Venezuela is located in the group of countries in the region of the Americas, with a moderate prevalence of tuberculosis, with rates estimated between 25 to 50 cases per 100.000 inhabitants. The high indexes of poverty, unemployment, illiteracy and basic unsatisfied needs occurring in the indigenous population contribute to the increase of tuberculosis cases in the young population. The aim of this investigation was to determine the prevalence of pulmonary tuberculosis in indigenous and non-indigenous patients in the State of Zulia. The study was of the descriptive, retrospective, transversal and non-experimental type, using a total population of 889 cases during the period 1996-2005. The age group with the greater prevalence was 65 to 74 years (15.07 percent), with 53.65 percent for males and 40.4 percent for females. The indigenous population predominated (52.64 percent) over the non-aboriginal population (47.36 percent), with the Wayuu ethnic group representing 89.31 percent. It was determined that tuberculosis prevalence has increased over the years, probably due to deficiencies in preventive methods and adapted health promotion programs.

[Acute non-specific splenitis as indicator of systemic infection. Assessment of 71 autopsy cases]. / Esplenitis aguda inespecífica como indicador de infección sistémica. Evaluación de 71 casos de autopsias.

Classic pathology textbooks claim that acute splenitis reflects septic states, nevertheless, the evidence upon which that association is based remains unclear. We assessed the occurrence of acute splenitis, as an indicator of systemic infection, in 34 autopsies performed in patients in whom the cause of death was due to multiple organ dysfunction syndrome, secondary to sepsis (group A); and in 37 cases of death by non-infectious causes (group B). These necropsies were done during the period January 31, 1999-December 31, 2000, at the Pathology Department of the Hospital General del Sur "Dr. Pedro Iturbe", Maracaibo, Venezuela. Acute splenitis was observed in 79% of the cases in group A, whereas it was absent in group B (p < 0.001). Thirty three (97%) of the patients of group A did not receive antibiotic therapy, and died within the first 24 hours following admission. Our results suggest that based on a proper clinical-pathological correlation, non-specific acute splenitis constitutes a finding that reflects a septic state, at least in cases that do not receive anti-microbial therapy.

Esplenitis aguda inespecífica como indicador de infección sistémica: evaluación de 71 casos de autopsias / Non specific acute splenitis as an indicator of systemic infection: evaluation of 71 autopsy cases

Los textos clásicos de patología plantean que la presencia de esplenitis aguda es reflejo de estados sépticos, pero está poco clara la evidencia en la que se basa tal asociación. Se evaluó la presencia de esplenitis aguda inespecífica como indicador de infección sistémica en casos de autopsias clínica. Se seleccionaron 34 casos que presentaron síndrome de disfunción de órganos secundario a sepsis como causa de muerte (Grupo A) y 37 casos fallecidos por procesos no infecciosos (Grupo B), de las 145 autopsias clínicas practicadas en el lapso 31 de enero de 1999 - 31 de diciembre de 2000 en el Departamento de Patología del Hospital General del Sur "Dr. Pedro Iturbe" de Maracaibo - Venezuela. El 79 por ciento de los casos del grupo A presentó esplenitis aguda mientras que en el grupo B ningún caso la desarrolló (p< 0,001). Treinta y tres casos del grupo A (97 por ciento) fallecieron en las primeras 24 horas de su ingreso y no recibieron terapia antimicrobiana. Los resultados sugieren que bajo una correlación clínico patológica adecuada, la esplenitis aguda inespecífica es un hallazgo de manera significativa la presencia de un estado séptico, al menos en los casos que no reciben terapia anti-microbiana