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1.
Klin Lab Diagn ; 64(8): 484-489, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31479604

RESUMO

The aim of research was to evaluate the effectiveness of the effect of eradication therapy on the cytokine status of gastric juice in patients with chronic non-atrophic gastritis (CNG) and duodenal ulcer (DU) associated with Helicobacter pylori. Clinical observations and laboratory-instrumental studies performed in 95 patients aged 20 to 55 years with CNG and duodenal ulcer with determination of cytokine content of IL-1ß, IL-6 and TNF-α in the fasting portion of gastric juice. The most pronounced decrease in the content of proinflammatory cytokines in gastric juice on the background of treatment was found in patients of the 1st group who received combined therapy according to the scheme omeprazole + clarithromycin + amoxicillin. Analysis of the content of proinflammatory cytokines (IL-1ß, IL-6 and TNF-α) in gastric juice in patients with acute exacerbation showed that their concentration in all 8 patients after the course of therapy exceeded the norm (P < 0.05) and was IL -1ß - 30,30 + 1,15 pg/l, IL-6 - 10,4 + 0,83 pg / l and TNF-α - 32,5 + 1,13 pg / l. At the same time, the level of proinflammatory cytokines in gastric juice correlated with the degree of dissemination of H. pylori in the mucosa of the gastroduodenal zone. Helicobacter pylori infection in inflammation and ulceration in the mucous membrane of the stomach and duodenum, possibly in addition to other mechanisms, affects the activation of pro-inflammatory cytokines (IL-1beta, IL-6, TNF-alpha) in gastric juice. Incomplete eradication of H. Pylori after treatment during clinical endoscopic remission in patients with duodenal ulcer in the vast majority of cases is accompanied by the preservation of an increased level of pro-inflammatory cytokines in gastric juice, which may be one of the reasons for the relapse of the disease.


Assuntos
Citocinas/análise , Suco Gástrico/química , Gastrite/terapia , Infecções por Helicobacter/terapia , Adulto , Mucosa Gástrica , Gastrite/microbiologia , Helicobacter pylori , Humanos , Pessoa de Meia-Idade , Adulto Jovem
2.
Harefuah ; 158(6): 398-403, 2019 Jun.
Artigo em Hebraico | MEDLINE | ID: mdl-31215194

RESUMO

INTRODUCTION: Treatment of Helicobacter pylori (Hp) infection remains a challenge for both primary care physicians and gastroenterologists. Over the past years, resistance of Hp to antibiotics has increased in Israel and abroad. Macrolide resistance remains the single most important factor responsible for failure to eradicate the organism. Effective treatment for the eradication of Hp must consider local resistance patterns. For this reason, representatives with clinical and research experience in the field of Hp convened under the auspices of the Israel Gastroenterology Association (IGA) to review the medical literature regarding the diagnosis and treatment of Hp, with particular emphasis on studies emanating from our region, and to develop local guidelines. The IGA does not recommend the use of clarithromycin-based triple therapy for the first-line treatment of Hp infection. Options for the first-line treatment of Hp infection include concomitant therapy, bismuth-based quadruple therapy and sequential therapy. Additional recommendations highlight the need to treat Hp whenever it is diagnosed, given its oncogenic potential, while adhering to the outlined indications for testing. The IGA calls for prospective studies to assess the comparative efficacy of different treatment protocols in Israel.


Assuntos
Gastroenterologia , Infecções por Helicobacter , Amoxicilina , Antibacterianos , Farmacorresistência Bacteriana , Quimioterapia Combinada , Gastroenterologia/tendências , Infecções por Helicobacter/terapia , Helicobacter pylori , Humanos , Israel , Macrolídeos , Guias de Prática Clínica como Assunto , Estudos Prospectivos
3.
Curr Top Microbiol Immunol ; 421: 319-359, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31123895

RESUMO

The connection between inflammation and cancer was initially recognized by Rudolf Virchow in the nineteenth century. During the last decades, a large body of evidence has provided support to his hypothesis, and now inflammation is recognized as one of the hallmarks of cancer, both in etiopathogenesis and ongoing tumor growth. Infection with the pathogen Helicobacter pylori is the primary causal factor in 90% of gastric cancer (GC) cases. As we increase our understanding of how chronic inflammation develops in the stomach and contributes to carcinogenesis, there is increasing interest in targeting cancer-promoting inflammation as a strategy to treat GC. Moreover, once cancer develops and anti-cancer immune responses are suppressed, there is evidence of a substantial shift in the microenvironment and new targets for immune therapy emerge. In this chapter, we provide insight into inflammation-related factors, including T lymphocytes, macrophages, pro-inflammatory chemokines, and cytokines, which promote H. pylori-associated GC initiation and growth. While intervening with chronic inflammation is not a new practice in rheumatology or gastroenterology, this approach has not been fully explored for its potential to prevent carcinogenesis or to contribute to the treatment of GC. This review highlights current and possible strategies for therapeutic intervention including (i) targeting pro-inflammatory mediators, (ii) targeting growth factors and pathways involved in angiogenesis in the gastric tumor microenvironment, and (iii) enhancing anti-tumor immunity. In addition, we highlight a significant number of clinical trials and discuss the importance of individual tumor characterization toward offering personalized immune-related therapy.


Assuntos
Inflamação/imunologia , Inflamação/terapia , Neoplasias Gástricas/patologia , Neoplasias Gástricas/terapia , Citocinas/imunologia , Mucosa Gástrica/imunologia , Mucosa Gástrica/microbiologia , Mucosa Gástrica/patologia , Infecções por Helicobacter/imunologia , Infecções por Helicobacter/microbiologia , Infecções por Helicobacter/patologia , Infecções por Helicobacter/terapia , Helicobacter pylori/patogenicidade , Humanos , Inflamação/microbiologia , Inflamação/patologia , Neoplasias Gástricas/imunologia , Neoplasias Gástricas/microbiologia , Microambiente Tumoral
4.
Medicine (Baltimore) ; 98(15): e15180, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30985706

RESUMO

BACKGROUND: Due to decreasing eradication rate and increasing side effects, probiotics have gradually become an important supplement to standard eradication regimens for Helicobacter pylori. OBJECTIVE: To evaluate the effectiveness and safety of probiotics in facilitating the eradication of H pylori and to explore the best timing and duration of probiotic supplementation, use of eradication regimens, strains, locations, and common side effects. METHODS: Eligible studies were retrieved from the PubMed, EMBASE, Cochrane Library, Web of Science, and CNKI databases, and we applied the Stata 12.0 software for the standard meta-analysis and network meta-analysis. RESULTS: Forty eligible studies with 8924 patients were included in the analysis. We used a random-effects model (I = 52.1% and I = 81.4%) to analyze the eradication rate and the incidence of total side effects by intention to treat (ITT). Compared with the control group, a higher eradication rate (relative risk [RR] 1.140, 95% confidence interval (CI) 1.101-1.180, P < .001) and lower incidence of total side effects (RR 0.470, 95% CI 0.391-0.565, P < .001) were observed in the probiotic group. In the subgroup analysis, we evaluated the surface under the cumulative ranking curve scores for the before + same (75.2%), >2 weeks (92.6%), probiotic + quadruple regimen (99.9%), Lactobacillus (73.6%), multiple strains (72.1%), China (98.5%) groups. The rankings of common side effects are shown in Table 6. SUCRA scores for diarrhea (39.7%), abdominal pain (43.9%), nausea (78.8%), taste disturbance (99.6%), vomiting (7.1%), and constipation (30.9%) were reported. The consistency of all comparison groups was good. CONCLUSIONS: Probiotics improved the eradication rate and reduced side effects when added to the treatments designed to eradicate H pylori. The use of probiotics before the eradication treatment and throughout the eradication treatment, and also the use of probiotics for more than 2 weeks, exerted better eradication effects. Probiotics combined with the bismuth quadruple regimen was the best combination. Lactobacillus and multiple strains were better choices of probiotic strains. The eradication effect observed in China was better than the effect observed in other countries.


Assuntos
Infecções por Helicobacter/terapia , Helicobacter pylori , Probióticos/administração & dosagem , Humanos , Meta-Análise em Rede , Probióticos/efeitos adversos
5.
Hematol Oncol ; 37(2): 168-175, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30734341

RESUMO

We evaluated the role of 18-fluoro-2-deoxy-d-glucose positron emission tomography ([18F] FDG-PET) with computed tomography (CT) (PET/CT) as a diagnostic and prognostic tool in newly diagnosed marginal zone lymphoma (MZL) patients. This is a retrospective cohort study of patients with newly diagnosed MZL, treated with immunotherapy, chemotherapy regimens, surgery, or Helicobacter pylori eradication between 2008 and 2016 in a single tertiary center. Only patients who had a pretreatment PET/CT (P-PET/CT) were included. P-PET/CT, interim (I-PET/CT), and end-of-treatment PET/CT (E-PET/CT) studies were reviewed. P-PET/CT results were reported using two methods of evaluation, qualitative and semi quantitative: visual assessment (VAS) and maximal standardized uptake value (SUVmax), and I-PET and E-PET results were reported by Deauville 5-point score (DS) evaluation as well. Avidity of PET/CT was defined as abnormal uptake in any of these methods. The primary outcome was the prognostic role of P-PET/CT, I-PET/CT, and E-PET/CT on progression-free survival (PFS) and overall survival (OS). Data of 196 patients with MZL were identified, 110 of which had P-PET/CT and were included in this analysis. Median age was 67 years (range 18-93). The median follow-up period was 63 months (range 3-278). The median OS and PFS for the whole cohort were 63 (interquartile range 39-85) and 60 (interquartile range 37-76) months, respectively. The avidity of PET at baseline for the whole cohort was 70% (77/110 patients), for MALT lymphoma, 62.5% (40/64 patients), for NMZL, 76.4% (13/17 patients), and for SMZL, 82.7% (24/29 patients). When adjusted for IPI, sex, and comorbidities, positive E-PET/CT was associated with reduced PFS with a hazard ratio (HR) of 3.4 (95% CI, 1.27-9.14, P = 0.02). Positive E-PET/CT did not correlate with OS. However, there were only three events. P-PET/CT was not predictive of PFS or OS. Our study demonstrates that above 70% of MZL are FDG avid. Positive E-PET/CT is a strong prognostic factor for PFS.


Assuntos
Glucose-6-Fosfato/análogos & derivados , Infecções por Helicobacter , Helicobacter pylori , Linfoma de Zona Marginal Tipo Células B , Tomografia por Emissão de Pósitrons , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Intervalo Livre de Doença , Feminino , Glucose-6-Fosfato/administração & dosagem , Infecções por Helicobacter/diagnóstico por imagem , Infecções por Helicobacter/mortalidade , Infecções por Helicobacter/terapia , Humanos , Linfoma de Zona Marginal Tipo Células B/diagnóstico por imagem , Linfoma de Zona Marginal Tipo Células B/mortalidade , Linfoma de Zona Marginal Tipo Células B/terapia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Taxa de Sobrevida
6.
Eur J Clin Pharmacol ; 75(5): 639-645, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30694338

RESUMO

AIM: To determine the effect of Saccharomyces boulardii CNCM I-745 (S. boulardii) plus sequential therapy on Helicobacter pylori (H. pylori) eradication rate. METHODS: This open-label prospective study randomized (1:1) patients with confirmed H. pylori infection to standard sequential therapy of twice-daily (bid) omeprazole 20 mg plus amoxicillin 1 g for 5 days, followed by bid omeprazole 20 mg, clarithromycin 500 mg and metronidazole 500 mg for the next 5 days (control group), or sequential therapy plus bid S. boulardii 250 mg (experimental group). Adverse events (AEs) were recorded throughout the study, and the H. pylori eradication rate was determined 4 weeks after treatment. RESULTS: The study was conducted from May 2013 to May 2016 and included 199 patients (51.3% male; mean age 44.6 ± 13.6 years). The H. pylori eradication rate was higher in the experimental group than the control group (86.0% vs. 74.7%; P = 0.02). Compared with the control group, patients in the experimental group experienced a significantly lower overall incidence of AEs (17.0% vs. 55.7%; p < 0.001) and the incidence of antibiotic-associated diarrhea (2.0% vs. 46.4%; P = 0.02). The experimental group showed improved treatment compliance over the 10-day study period compared with the control group (95.0% vs. 91.2%, P < 0.001). CONCLUSION: Addition of S. boulardii to sequential therapy improved H. pylori eradication rate and reduced the incidence of treatment-associated AEs in Moroccan patients with H. pylori infection.


Assuntos
Infecções por Helicobacter/terapia , Helicobacter pylori/efeitos dos fármacos , Probióticos/uso terapêutico , Saccharomyces boulardii , Adulto , Amoxicilina/efeitos adversos , Amoxicilina/uso terapêutico , Antibacterianos/efeitos adversos , Antibacterianos/uso terapêutico , Claritromicina/efeitos adversos , Claritromicina/uso terapêutico , Feminino , Infecções por Helicobacter/tratamento farmacológico , Humanos , Masculino , Metronidazol/efeitos adversos , Metronidazol/uso terapêutico , Pessoa de Meia-Idade , Omeprazol/efeitos adversos , Omeprazol/uso terapêutico , Estudos Prospectivos , Inibidores da Bomba de Prótons/efeitos adversos , Inibidores da Bomba de Prótons/uso terapêutico , Distribuição Aleatória
7.
Appl Microbiol Biotechnol ; 103(4): 1573-1588, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30610283

RESUMO

Helicobacter pylori is a highly prevalent human pathogen responsible for chronic inflammation of the gastric tissues, gastroduodenal ulcers, and cancer. The treatment includes a pair of antibiotics with a proton pump inhibitor PPI. Despite the presence of different treatments, the infection rate is still increasing both in developed and developing states. The challenge of treatment failure is greatly due to the resistance of H. pylori to antibiotics and its side effects. Probiotics potential to cure H. pylori infection is well-documented. Probiotics combined with conventional treatment regime appear to have great potential in eradicating H. pylori infection, therefore, provide an excellent alternative approach to manage H. pylori load and its threatening disease outcome. Notably, anti-H. pylori activity of probiotics is strain specific,therefore establishing standard guidelines regarding the dose and formulation of individual strain is inevitable. This review is focused on probiotic's antagonism against H. pylori summarizing their three main potential aspects: their efficiency (i) as an alternative to H. pylori eradication treatment, (ii) as an adjunct to H. pylori eradication treatment and (iii) as a vaccine delivery vehicle.


Assuntos
Antibiose , Infecções por Helicobacter/terapia , Helicobacter pylori/crescimento & desenvolvimento , Probióticos/administração & dosagem , Humanos
8.
J Int Med Res ; 47(2): 875-883, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30616462

RESUMO

OBJECTIVES: This study aimed to evaluate the effects of periodontal therapy on the efficacy of Helicobacter pylori eradication and on the recurrence of infection after eradication. METHODS: We conducted a prospective randomized trial on 698 gastric H. pylori-infected patients, of whom 347 received gastric H. pylori treatment alone and 342 received gastric H. pylori treatment plus periodontal therapy. The presence of H. pylori and associated virulence genes were detected by real-time polymerase chain reaction. RESULTS: After eradication of gastric H. pylori infection, the recurrence of gastric H. pylori was significantly lower in the gastric H. pylori treatment plus periodontal therapy group than in the group receiving gastric H. pylori treatment alone (OR 0.67; 95% CI 0.45 to 0.99), whereas the eradication rate was not significantly different (OR 0.87; 95% CI 0.68 to 0.98). There was a close relationship between the presence of H. pylori in saliva and its presence in the stomach. CONCLUSIONS: The oral cavity is an important reservoir for gastric H. pylori infection. Adjunctive periodontal therapy could enhance the efficiency of H. pylori treatment and reduce the recurrence of gastric H. pylori infection.


Assuntos
Antibacterianos/uso terapêutico , Infecções por Helicobacter/terapia , Helicobacter pylori/isolamento & purificação , Doenças Periodontais/terapia , Saliva/microbiologia , Gastropatias/microbiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Seguimentos , Infecções por Helicobacter/microbiologia , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Periodontais/microbiologia , Prognóstico , Estudos Prospectivos , Recidiva , Gastropatias/tratamento farmacológico , Adulto Jovem
9.
Rev. Hosp. Clin. Univ. Chile ; 30(1): 3-11, 2019. Tab., Graf.
Artigo em Espanhol | LILACS | ID: biblio-1005532

RESUMO

Helicobacter pylori (HP) is the most widely chronic human infection around the world, and the main risk factor for the development of gastric cancer. Our country has high rates of this neoplasia and a high prevalence of HP infection. Even both have fallen in the last year, is a major concern to diagnose the population infected with HP in early stages, before the development of premalignant lesions and properly eradicate this infection. In this review, we discussed the different methods for the diagnosis of HP and factors that change positivity as the use of proton pump inhibitors. Also, we discussed the factors to be considered in the choice of the treatment, like local resistance to antibiotics, specially clarithromycin. In the last years has been documented in Chile a significant increase in resistance to clarithromycin, from 20 to 46%, which predicts inadequate effectiveness for the classic triple therapy. As the result of the previous analysis we discussed new possible therapies, including bismuth quadruple therapy and concomitant therapy. (AU)


Assuntos
Humanos , Masculino , Feminino , Helicobacter pylori , Helicobacter pylori/patogenicidade , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/terapia , Infecções por Helicobacter/epidemiologia
10.
Arq Gastroenterol ; 55(3): 279-282, 2018 Jul-Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30540092

RESUMO

BACKGROUND: Helicobacter pylori (H. pylori) has been introduced by since 1983 by Marshal and Warren to play the main role in the pathophysiology of gastritis and gastric ulcers. Almost half of the world population1 is infected by H. pylori. Current therapeutic regimen against H. pylori includes the use of a proton pump inhibitor plus two or more antibiotics. However, the efficacy of this regimen is decreasing mainly due to antibiotic resistance and side effects of medications. This fact has resulted in public interest in other therapeutic options and the role of probiotics merits special attention in this regard. OBJECTIVE: This study aims to evaluate the efficacy of honey-derived Lactobacillus rhamnosus on H. pylori-induced gastric inflammation and gastro-intestinal infection in C57BL/6 Mice. METHODS: The 24 C57BL/6 Mice were randomly divided into three groups of eight mice each. All the mice were fed with 1cc suspension containing 5*1010 CFU/ mL of ATCC43504 strains of H. pylori for 3 consecutive days, twice daily via polyethylene gavage tubes. At the end of 4th week, infection with H. pylori was confirmed with stool Ag (ELISA) and following sacrifice of one mouse from each group, histopathologic study confirmed gastritis. The groups were subjected to different therapies as stated, 1: without Bismuth (Bi), Omeprazole (Om) and L. rhamnosus prescription, 2: Bi, Om and Clarithromycin (Cl) and 3: Bi, Om plus 1cc of suspension of 109 CFU/mL of L. rhamnosus. After 2 weeks, the stool was analyzed for Ag and the mice were sacrificed for evaluation of histopathologic changes. RESULTS: Treatment with L. rhamnosus group provided Zero titer of stool Ag and was associated with improved gastric inflammation in all subjects, similar to the clarithromycin group. CONCLUSION: Honey-derived L. rhamnosus probiotics provides similar results as clarithromycin in terms of improvement of H. pylori infection and gastritis in C57BL/6 Mice model, without its cons of antibiotic resistance.


Assuntos
Gastrite/terapia , Infecções por Helicobacter/terapia , Helicobacter pylori , Mel/microbiologia , Lactobacillus rhamnosus , Probióticos/uso terapêutico , Animais , Antibacterianos/farmacologia , Claritromicina/farmacologia , Contagem de Colônia Microbiana , Modelos Animais de Doenças , Ensaio de Imunoadsorção Enzimática , Mucosa Gástrica/microbiologia , Mucosa Gástrica/patologia , Gastrite/microbiologia , Infecções por Helicobacter/microbiologia , Masculino , Camundongos Endogâmicos C57BL , Distribuição Aleatória , Reprodutibilidade dos Testes , Fatores de Tempo , Resultado do Tratamento
11.
Surg Clin North Am ; 98(5): 933-944, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30243454

RESUMO

The management of peptic ulcer disease has radically changed over the last 40 years from primarily surgical treatment to medical therapy nearly eliminating the need for elective surgery in these patients. Although there has been a decline in patients requiring acute surgical intervention for complications of peptic ulcer disease (perforation, bleeding, and obstruction), these patients still make up a significant proportion of hospital admissions every year. The modern acute care surgeon must have significant knowledge of the multiple treatment modalities used to appropriately care for these patients.


Assuntos
Úlcera Péptica/etiologia , Úlcera Péptica/terapia , Infecções por Helicobacter/complicações , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/terapia , Helicobacter pylori , Humanos , Úlcera Péptica/diagnóstico
12.
Arq Gastroenterol ; 55(2): 97-121, 2018 Apr-Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30043876

RESUMO

Significant progress has been obtained since the III Brazilian Consensus Conference on H. pylori infection held in 2012, in Bento Gonçalves, Brazil, and justify a fourth meeting to establish updated guidelines on the current management of H. pylori infection. Therefore, the Núcleo Brasileiro para Estudo do Helicobacter pylori e Microbiota (NBEHPM), association linked to Brazilian Federation of Gastroenterology (FBG) held its fourth meeting again in Bento Gonçalves, RS, Brazil, on August 25-27, 2017. Twenty-six delegates, including gastroenterologists, endoscopists, and pathologists from the five regions of Brazil as well as one international guest from the United States, participated in the meeting. The participants were invited based on their knowledge and contribution to the study of H. pylori infection. The meeting sought to review different aspects of treatment for infection; establish a correlation between infection, dyspepsia, intestinal microbiota changes, and other disorders with a special emphasis on gastric cancer; and reassess the epidemiological and diagnostic aspects of H. pylori infection. Participants were allocated into four groups as follows: 1) Epidemiology and Diagnosis, 2) Dyspepsia, intestinal microbiota and other afections, 3) Gastric Cancer, and, 4) Treatment. Before the consensus meeting, participants received a topic to be discussed and prepared a document containing a recent literature review and statements that should be discussed and eventually modified during the face-to-face meeting. All statements were evaluated in two rounds of voting. Initially, each participant discussed the document and statements with his group for possible modifications and voting. Subsequently, during a second voting in a plenary session in the presence of all participants, the statements were voted upon and eventually modified. The participants could vote using five alternatives: 1) strongly agree; 2) partially agree; 3) undecided; 4) disagree; and 5) strongly disagree. The adopted consensus index was that 80% of the participants responded that they strongly or partially agreed with each statement. The recommendations reported are intended to provide the most current and relevant evidences to management of H. pylori infection in adult population in Brazil.


Assuntos
Dispepsia/microbiologia , Microbioma Gastrointestinal/fisiologia , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/terapia , Neoplasias Gástricas/microbiologia , Adulto , Animais , Antibacterianos/uso terapêutico , Brasil , Medicina Baseada em Evidências , Infecções por Helicobacter/complicações , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori/efeitos dos fármacos , Helicobacter pylori/isolamento & purificação , Humanos
13.
Rev Gastroenterol Peru ; 38(1): 40-43, 2018 Jan-Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29791420

RESUMO

OBJECTIVE: To present and discuss the endoscopic and histological results, as well as the incidence of Helicobacter pylori and other diseases, indications and characteristics of upper digestive endoscopies performed in children. MATERIAL AND METHODS: Twenty-five endoscopies were performed in children aged six months to 11 years (mean 7.69 years), from February 2013 to January 2016. In 200 patients, endoscopies were diagnostic and serial biopsies were performed (esophagus, stomach and duodenum), in 120 of them. RESULTS: The indication of endoscopy was diagnosed in 88.89% of the patients, and in 26 patients, a therapeutic procedure was performed. The most frequent endoscopic findings were esophagitis in 49 patients, gastritis in 84 and duodenitis in 16 patients. Four duodenal ulcers were diagnosed. In the therapeutic endoscopies, six gastrostomies were performed, 14 foreign body withdrawals, five nasoenteral tube passages and esophageal dilatation. The H. pylori survey was performed by anatomopathological method and was positive in 26 (13%) of the 200 patients in whom it was searched. CONCLUSION: pediatric endoscopy is an important niche of the digestive endoscopy, where it is important to emphasize the relevance of the institutional structure that performs these procedures, in order to conduct them safely, being able to treat possible and feasible complications.


Assuntos
Úlcera Duodenal/diagnóstico por imagem , Duodenite/diagnóstico por imagem , Endoscopia Gastrointestinal , Esofagite/diagnóstico por imagem , Gastrite/diagnóstico por imagem , Infecções por Helicobacter/diagnóstico por imagem , Helicobacter pylori , Brasil/epidemiologia , Criança , Pré-Escolar , Úlcera Duodenal/epidemiologia , Úlcera Duodenal/terapia , Duodenite/epidemiologia , Duodenite/terapia , Esofagite/epidemiologia , Esofagite/terapia , Gastrite/epidemiologia , Gastrite/terapia , Infecções por Helicobacter/epidemiologia , Infecções por Helicobacter/terapia , Humanos , Incidência , Lactente , Estudos Retrospectivos , Resultado do Tratamento
14.
Hematology ; 23(9): 658-663, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29637844

RESUMO

OBJECTIVES: To determine the referral patterns and etiology of iron deficiency anemia (IDA) at an academic hematology center in northeast Mexico. METHODS: We included all consecutive outpatients older than 16 years, non-pregnant, with IDA diagnosed in the Hematology Service of the Dr. José E. González University Hospital between January 2012 and May 2017. Appropriate data were collected retrospectively from the electronic medical record. Data regarding first medical contact (primary care physician or hematologist) were compared. RESULTS: One hundred fifty-three patients were included in this study. The median age was 43 years (interquartile range, 35-51) and 85.6% were female; 128 (83.7%) patients were seen by a primary care physician before our evaluation. Abnormal uterine bleeding (AUB) was the cause of IDA in 76 patients (49.6%), gastrointestinal bleeding (GIB) in 31 (20.2%), H. pylori infection in 12 (7.8%), urinary tract bleeding in three (1.9%) and malabsorption-syndrome in two (1.3%). The etiology remained unknown in 29 (18.9%). The p value was <0.05 between groups according to the first medical contact, including frequency of at least one sign or symptom of IDA, previous use of iron supplementation and blood transfusion, comorbidities, complete blood count at diagnosis, and resolution rates of anemia. CONCLUSION: The majority of our IDA patients were referred by another physician. Nearly half of the patients with IDA had AUB. IDA remains a diagnostic challenge for first contact physicians requiring a targeted educational intervention to improve IDA awareness and diagnostic skills.


Assuntos
Anemia Ferropriva/epidemiologia , Infecções por Helicobacter/epidemiologia , Helicobacter pylori , Hemorragia/epidemiologia , Adulto , Anemia Ferropriva/etiologia , Anemia Ferropriva/terapia , Feminino , Infecções por Helicobacter/complicações , Infecções por Helicobacter/terapia , Hemorragia/complicações , Hemorragia/terapia , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Encaminhamento e Consulta , Estudos Retrospectivos
15.
Digestion ; 97(1): 6-12, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29393229

RESUMO

In the annual meeting of the Japan Gastroenterological Association (JGA), the scientific organizing committee selected the serial topics for the core symposium. One of the core symposia held during 2015-2017 was entitled "New medical approach to functional dyspepsia (FD)." In 2015, the subtitle of this symposium was "Helicobacter pylori gastritis and FD." In 2016, the subtitle of this symposium was "overlap with other functional GI disorders." In 2017, the subtitle was "therapeutic approach to FD." During these 3 years, a total of 24 presentations were included in Core Symposium 3 and deep and intensive discussions were carried out.


Assuntos
Antibacterianos/uso terapêutico , Dispepsia/terapia , Gastroenterologia/métodos , Infecções por Helicobacter/terapia , Inibidores da Bomba de Prótons/uso terapêutico , Congressos como Assunto , Conferências de Consenso como Assunto , Dispepsia/genética , Dispepsia/microbiologia , Dispepsia/fisiopatologia , Gastroenterologia/tendências , Motilidade Gastrointestinal , Infecções por Helicobacter/genética , Infecções por Helicobacter/microbiologia , Infecções por Helicobacter/fisiopatologia , Helicobacter pylori/genética , Helicobacter pylori/isolamento & purificação , Humanos , Japão , Qualidade de Vida
16.
Transfus Apher Sci ; 57(1): 88-90, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29398507

RESUMO

We report a case of a patient with high titer anti-H antibody showing broad thermal amplitude and variable reactivities against group A red cells. A 62-year-old Korean female was diagnosed with diffuse large B cell lymphoma involving multiple organs. Her ABO/RhD type was A+ and her genotype was ABO*A.01.01/ABO*O.01.02. Antibody screening test (AST) and antibody identification test (IDT) were strongly positive for all reagent cells. Anti-human globulin (AHG) test revealed an antibody titer of 1:256 for 37 °C phase and trace positivity for poly- and mono-specific C3d. Reactivity was stronger for O+ red cells than that for A+ red cells across all temperatures tested (4 °C, room temperature (RT) and 37 °C). This was also found for AHG phase. Anti-IH was ruled out based on agglutination of O+ cord cells (CCs). Antibody was determined as IgM anti-H after DTT treatment. Three batches of 10 A+ red cells from random donors were tested with three consecutive serums for crossmatching using tube method. Interestingly, out of thirty A+ red cells tested, 20 cells at RT, 11 cells at 37 °C and 11 cells in the AHG phase showed reactivity of greater than 2+. The patient was transfused with 6 units of packed RBCs subsequently. Chemotherapy (R-CHOP regimen) and Helicobacter pylori eradication were then started. Her antibody titer gradually decreased following such treatment. In conclusion, we identified a case of patient with high titer anti-H with broad thermal amplitude, suggesting that anti-H antibodies might need to be considered for cases with pan-agglutination in AST and IDT.


Assuntos
Sistema do Grupo Sanguíneo ABO , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Transfusão de Eritrócitos , Genótipo , Infecções por Helicobacter , Helicobacter pylori , Isoanticorpos/sangue , Linfoma Difuso de Grandes Células B , Sistema do Grupo Sanguíneo ABO/sangue , Sistema do Grupo Sanguíneo ABO/genética , Idoso , Anticorpos Monoclonais Murinos/administração & dosagem , Ciclofosfamida/administração & dosagem , Doxorrubicina/administração & dosagem , Feminino , Infecções por Helicobacter/sangue , Infecções por Helicobacter/genética , Infecções por Helicobacter/terapia , Humanos , Linfoma Difuso de Grandes Células B/sangue , Linfoma Difuso de Grandes Células B/genética , Linfoma Difuso de Grandes Células B/terapia , Prednisona/administração & dosagem , Vincristina/administração & dosagem
17.
World J Gastroenterol ; 24(1): 139-149, 2018 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-29358890

RESUMO

AIM: To define probiotic monotherapy effect on Helicobacter pylori (H. pylori) status by performing a systematic review. METHODS: Methods of analysis and inclusion criteria were based on PRISMA recommendations. Relevant publications were identified by searching PubMed, MEDLINE, Science Direct, and EMBASE. The end-point was to estimate eradication rate and urea breath test delta value before and after probiotic monotherapy across all studies and, overall, with a pooled data analysis. Adverse events of probiotic therapy were evaluated. The data were expressed as proportions/percentages, and 95%CIs were calculated. For continuous variables, we evaluated the weighted mean difference. Odd ratios (ORs) were calculated according to the Peto method for the comparison of eradication rates between probiotics and placebo. RESULTS: Eleven studies were selected. Probiotics eradicated H. pylori in 50 out of 403 cases. The mean weighted eradication rate was 14% (95%CI: 2%-25%, P = 0.02). Lactobacilli eradicated the bacterium in 30 out of 235 patients, with a mean weighted rate of 16% (95%CI: 1%-31%). Saccharomyces boulardii achieved eradication in 6 out of 63 patients, with a pooled eradication rate of 12% (95%CI: 0%-29%). Multistrain combinations were effective in 14 out of 105 patients, with a pooled eradication rate of 14% (95%CI: 0%-43%). In the comparison of probiotics vs placebo, we found an OR of 7.91 in favor of probiotics (95%CI: 2.97-21.05, P < 0.001). Probiotics induced a mean reduction in delta values higher than placebo (8.61% with a 95%CI: 5.88-11.34, vs 0.19% for placebo, P < 0.001). Finally, no significant difference in adverse events was found between probiotics and placebo (OR = 1, 95%CI: 0.06-18.08). CONCLUSION: Probiotics alone show a minimal effect on H. pylori clearance, thus suggesting a likely direct role.


Assuntos
Infecções por Helicobacter/terapia , Helicobacter pylori/patogenicidade , Probióticos/uso terapêutico , Adolescente , Adulto , Idoso , Testes Respiratórios , Distribuição de Qui-Quadrado , Criança , Feminino , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/microbiologia , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Probióticos/efeitos adversos , Fatores de Risco , Resultado do Tratamento , Adulto Jovem
18.
Methods Mol Biol ; 1693: 3-10, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29119427

RESUMO

One of the most important factors for successful bacteriophage therapy is, undoubtedly, the isolation of excellent therapeutic candidate bacteriophages. There are only a few reports about active bacteriophages in the fastidious bacteria Helicobacter pylori. In this chapter, we describe a method for isolating and purifying KHP30-like bacteriophages in H. pylori, which have lytic and pseudolysogenic life cycles.


Assuntos
Bacteriófagos/isolamento & purificação , Bacteriófagos/fisiologia , Helicobacter pylori/virologia , DNA Viral/genética , Infecções por Helicobacter/terapia , Helicobacter pylori/genética , Humanos
19.
Rev Gastroenterol Mex ; 83(1): 16-24, 2018 Jan - Mar.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28385468

RESUMO

BACKGROUND: Helicobacter pylori (Hp) infection is one of the most common infections in humans. Due to its worldwide prevalence, a series of guidelines and recommendations has been developed for the appropriate screening, diagnosis, and management of patients with Hp infection. AIM: To evaluate the approach, attitudes, and knowledge of a group of Mexican general practitioners in relation to Hp. MATERIALS AND METHODS: A cross-sectional study was conducted that evaluated the knowledge of Hp diagnosis and treatment through the application of a questionnaire. RESULTS: From the total of 430 questionnaires delivered, information was obtained from 411 (95% response rate). The most frequent indications for eradication treatment were peptic ulcer (48.4%), gastroesophageal reflux disease (41.8%), and dyspepsia (39.2%). Thirty-one percent of the physicians surveyed used more than one test to look for Hp, and serology was the most commonly employed method. The most widely used antibiotic regimen was clarithromycin plus amoxicillin (63.8%), followed by metronidazole plus tetracycline (16%). Ninety-two percent of the physicians confirmed eradication through endoscopy for the histologic analysis and only 23% utilized the breath test. CONCLUSIONS: Our results show the lack of knowledge about the established diagnostic and treatment recommendations for Hp infection. The implementation of workshops, courses, and conferences, or the formulation of practical guidelines should be directed at primary care physicians to strengthen the practice of medicine based on scientific evidence.


Assuntos
Atitude do Pessoal de Saúde , Competência Clínica/estatística & dados numéricos , Medicina Geral/estatística & dados numéricos , Infecções por Helicobacter , Helicobacter pylori , Padrões de Prática Médica/estatística & dados numéricos , Adulto , Idoso , Estudos Transversais , Feminino , Medicina Geral/normas , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/terapia , Humanos , Masculino , México , Pessoa de Meia-Idade , Padrões de Prática Médica/normas , Inquéritos e Questionários
20.
Cienc. tecnol. salud ; 5(1): 54-62, 2018. ilus 27 cm
Artigo em Espanhol | LILACS | ID: biblio-965189

RESUMO

La infección por Helicobacter pylori es una de las infecciones crónicas más comunes a nivel mundial y causa importante de enfermedad péptica y cáncer gástrico. Infecta al 50% de la población adulta con mayor prevalencia en América Central/Sur y Asia y al menos dos veces mayor en poblaciones con alta incidencia de cáncer gástrico. Los objetivos de esta investigación fueron identificar la tasa de erradicación de H. pylori con terapia triple estándar y las posibles características asociadas a su erradicación. Se estudió a 119 pacientes con diagnóstico de infección por H. pylori, seleccionados en forma consecutiva de la consulta externa de Gastroenterología del Hospital General San Juan de Dios. Se realizó endoscopia diagnóstica y toma de biopsia gástrica. Se dio terapia triple estándar con lansoprazol, amoxicilina y claritromicina durante 10 días, seguido de 30 días con lansoprazol. Seis semanas después de completado el tratamiento se evaluó el antígeno de H. pylori en heces para determinar si hubo erradicación. La edad promedio de los participantes fue 49.0 años, 81.5% mujeres, 85.7% de área urbana, el síntoma más común fue dispepsia en 86.6%. En el examen post tratamiento el 89.9%, IC 95% [83.0, 94.7] presentó antígeno en heces negativo. No se encontró asociación entre las características de los pacientes con la respuesta al tratamiento. En conclusión, la respuesta a la terapia triple de primera línea se encuentra dentro del rango aceptable para continuar con ese esquema, pero debe mantenerse una evaluación constante por la presencia de posible resistencia.


Infection by Helicobacter pylori is one of the most common chronic infections worldwide and an important cause of peptic disease and gastric cancer. It infects 50% of the adult population with the highest prevalence in Central / South America and Asia and at least twice as high in populations with a high incidence of gastric cancer. The objectives of this research were to identify the eradication rate of H. pylori after first line standard triple therapy and the possible characteristics associated with its eradication. It was studied 119 patients with a diagnosis of H. pylori infection, selected consecutively from the outpatient department of Gastroenterology of the San Juan de Dios General Hospital. Diagnostic endoscopy and gastric biopsy was performed. Standard triple therapy was given with lansoprazole, amoxicillin and clarithromycin for 10 days, followed by 30 days with lansoprazole. Six weeks after the treatment was completed, the H. pylori antigen in feces was evaluated to determine if there was eradication. The average age of the participants was 49.0 years, 81.5% women, 85.7% of urban area, the most common symptom was dyspepsia in 86.6%. In the post-treatment examination 89.9%, 95% CI [83.0, 94.7] presented negative antigen in feces. No association was found between the characteristics of the patients with the response to treatment. In conclusion, the response to first line triple therapy is within the acceptable range to continue with this scheme, but a constant evaluation must be maintained due to the presence of possible resistance.


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Infecções por Helicobacter/terapia , Dispepsia/tratamento farmacológico , Azia/diagnóstico , Neoplasias Gastrointestinais
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