Helicobacter pylori Infection: A 40-Year Journey through Shifting the Paradigm to Transforming the Management.

BACKGROUND: Helicobacter pylori (H. pylori) was discovered 40 years ago and has set a milestone in human medicine. The discovery led to rejection of the dogma of the acidic stomach as a sterile organ and requested to rewrite the chapters on gastric pathophysiology and gastroduodenal diseases. SUMMARY: Over a period of 40 years following the discovery, more than 50,000 articles can be retrieved in PubMed as of today and illustrate the amount and the intensity of research around the role of this bacterium. H. pylori emerged as cause of chronic gastritis and principal cause of peptic ulcer disease (PUD). Eradication of H. pylori became standard of care in management in PUD. The importance of this was highlighted in 2005 with the Nobel Prize in Medicine awarded to Barry Marshall and Robin Warren. H. pylori became eventually recognized for its oncogenic potential in the stomach and as the main risk factor for gastric cancer development. KEY MESSAGES: H. pylori gastritis is defined as infectious disease and requires therapy in all infected individuals. Strategies of gastric cancer prevention and development of therapies to overcome the increasing antibiotic resistance are main targets in clinical research of today.

Joint ESPGHAN/NASPGHAN Guidelines on Childhood Eosinophilic Gastrointestinal Disorders Beyond Eosinophilic Esophagitis.

INTRODUCTION: Eosinophilic gastrointestinal disorders beyond eosinophilic esophagitis (non-EoE EGIDs) are rare chronic inflammatory disorders of the gastrointestinal (GI) tract. Diagnosis is based on clinical symptoms and histologic findings of eosinophilic inflammation after exclusion of a secondary cause or systemic disease. Currently, no guidelines exist for the evaluation of non-EoE EGIDs. Therefore, the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) formed a task force group to provide consensus guidelines for childhood non-EoE EGIDs. METHODS: The working group was composed of pediatric gastroenterologists, adult gastroenterologists, allergists/immunologists, and pathologists. An extensive electronic literature search of the MEDLINE, EMBASE, and Cochrane databases was conducted up to February 2022. General methodology was used in the formulation of recommendations according to the Appraisal of Guidelines for Research and Evaluation (AGREE) II and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to meet current standards of evidence assessment. RESULTS: The guidelines provide information on the current concept of non-EoE EGIDs, disease pathogenesis, epidemiology, clinical manifestations, diagnostic and disease surveillance procedures, and current treatment options. Thirty-four statements based on available evidence and 41 recommendations based on expert opinion and best clinical practices were developed. CONCLUSION: Non-EoE EGIDs literature is limited in scope and depth, making clear recommendations difficult. These consensus-based clinical practice guidelines are intended to assist clinicians caring for children affected by non-EoE EGIDs and to facilitate high-quality randomized controlled trials of various treatment modalities using standardized, uniform disease definitions.

Histopathology of Eosinophilic Gastrointestinal Diseases Beyond Eosinophilic Esophagitis.

Eosinophilic gastrointestinal diseases (EGID), such as eosinophilic gastritis (EoG), eosinophilic enteritis, and eosinophilic colitis (EoC), are chronic inflammatory conditions characterized by persistent gastrointestinal symptoms and elevated levels of activated eosinophils in the gastrointestinal tract. EoG and eosinophilic duodenitis (EoD) are strongly associated with food allergen triggers and TH2 inflammation, whereas EoC shows minimal transcriptomic overlap with other EGIDs. The level of expression of certain genes associated with TH2 immune response is associated with certain histopathologic findings of EoG, EoD, and EoC. Current immune therapy for EoG depletes tissue eosinophilia with persistence of other histopathologic features of disease.

Dietary Management of Non-EoE Eosinophilic Gastrointestinal Diseases.

Patients with non-eosinophilic esophagitis eosinophilic gastrointestinal diseases (non-EoE EGIDs) are prone to nutritional deficiencies due to food-avoidant behaviors, malabsorption, and high nutrition impact symptoms. Nutrient deficiencies correspond to the segment, depth, and extent of the gastrointestinal tract involved and can impact organs distant from the gut. Patients with non-EoE EGIDs are often atopic, and some appear to respond to dietary avoidance of specific food allergens. Tests to identify food triggers other than response to elimination diets are lacking. Dietary restriction therapy should be considered in such patients and is best implemented through a multidisciplinary approach to avoid nutritional complications.

Role of Mast Cells in Eosinophilic Gastrointestinal Diseases.

Mast cells play a central role in the pathogenesis of eosinophilic gastrointestinal disorders (EGIDs), including eosinophilic esophagitis. Their interactions with immune and structural cells, involvement in tissue remodeling, and contribution to symptoms make them attractive targets for therapeutic intervention. More is being discovered regarding the intricate interplay of mast cells and eosinophils. Recent studies demonstrating that depletion of eosinophils is insufficient to improve symptoms of EGIDs have raised the question of whether other cells may play a role in symptomatology and pathogenesis of EGIDs.

Clinical guideline highlight for the hospitalist: Childhood eosinophilic gastrointestinal disorders beyond eosinophilic esophagitis.

GUIDELINE TITLE: Joint ESPGHAN/NASPGHAN Guidelines on Childhood Eosinophilic Gastrointestinal Disorders Beyond Eosinophilic Esophagitis RELEASE DATE: July 4, 2023 (e-publication ahead of print) PRIOR VERSION(S): None DEVELOPER: European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the North American Society for Pediatrics Gastroenterology, Hepatology and Nutrition (NASPGHAN) FUNDING SOURCE: ESPGHAN and NASPGHAN TARGET POPULATION: Children with eosinophilic gastrointestinal disorders beyond eosinophilic esophagitis.

Barriers to Timely Diagnosis of Eosinophilic Gastrointestinal Diseases.

Although eosinophilic gastrointestinal diseases, including eosinophilic esophagitis, have been described over the past 2 to 3 decades, barriers to diagnosis and treatment are common and compounded by issues related to social determinants of health, race, ethnicity, and access to care. These barriers contribute to delays in diagnosis, resulting in persistent inflammation in the gastrointestinal tract, which can have significant consequences, including fibrostenotic complications in adults, failure to thrive in children, and decreased quality of life in all affected patients. In this commentary, we summarize gaps in knowledge regarding the epidemiology of eosinophilic gastrointestinal diseases, highlight barriers to diagnosis, discuss potential approaches based on best practices in other atopic and chronic gastrointestinal diseases, and provide recommendations for reducing barriers to timely diagnosis of eosinophilic gastrointestinal diseases in underserved populations.

Gastric microbiota transplantation as a potential treatment for immune checkpoint inhibitor-associated gastritis.

Immune-related adverse events (irAEs) are complications of the use of immune checkpoint inhibitors (ICIs). ICI-associated gastritis is one of the main irAEs. The gastric microbiota is often related to the occurrence and development of many gastric diseases. Gastric microbiota adjustment may be used to treat gastric disorders in the future. Faecal microbiota transplantation can alter the gut microbiota of patients and has been used for treating ICI-associated colitis. Therefore, we propose gastric microbiota transplantation as a supplementary treatment for patients with ICI-associated gastritis who do not respond well to conventional therapy.

Gastritis enfisematosa. Reporte de un caso en el adulto mayor / Emphysematous gastritis. Report of a case in the elderly

Introducción: la gastritis enfisematosa es una patología poco común pero con alta mortalidad, su presentación clínica es insidiosa, la imagen por tomografía se distingue por un patrón de burbujas lineales con engrosamiento de la pared gástrica. Caso clínico: paciente masculino de 78 años, previamente sano, funcional, que fue ingresado por fractura pertrocantérica de cadera izquierda, quien durante la hospitalización presenta delirium hiperactivo, distención abdominal con disminución de perístalsis además de hipotensión arterial, se realiza tomografía abdominal con evidencia de dilatación gástrica y múltiples burbujas de aire en pared. Es manejado con antibiótico de amplio espectro, fluidoterapia y nutrición parenteral, con respuesta favorable.Conclusiones: la edad avanzada no conlleva por sí misma un peor pronóstico de la enfermedad, la evidencia apoya que un diagnóstico precoz y la intervención terapéutica temprana, son las medidas que han demostrado ser efectivas para la disminución de la mortalidad en pacientes con gastritis enfisematosa

Introduction: Emphysematous gastritis is an uncommon pathology but with high mortality, its clinical presentation is insidious, the tomography image is distinguished by a pattern of linear bubbles with thickening of the gastric wall.Background: This is a 78-year-old male, previously healthy, functional, who was admitted for pertrochanteric fracture of the left hip, who during hospitalization presented hyperactive delirium, abdominal distention with decreased perstalsis in addition to arterial hypotension, an abdominal tomography with evidence of gastric dilation and multiple air bubbles in the wall. He is managed with a broad spectrum antibiotic, fluid therapy and parenteral nutrition, with a favorable response.Conclusions: Advanced age does not in itself lead to a worse disease prognosis, the evidence supports that early diagnosis and early therapeutic intervention are the easures that have proven to be more effective in reducing mortality in patients with emphysematous gastritis.

O mel-derivado de Lactobacillus rhamnosus alivia a infecção gastro-intestinal induzida pelo Helicobacter pylori-e inflamação gástrica em C57Bl/6 ratos: um estudo imuno-histológico / Honey-derived lactobacillus rhamnosus alleviates helicobacter pylori-induced gastro-intestinal infection and gastric inflammation in c57bl/6 mice: an immuno-histologic study

ABSTRACT 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.

RESUMO CONTEXTO: O Helicobacter pylori (H. pylori) foi reconhecido em 1983 por Marechal e Warren como protagonista principal na fisiopatologia de gastrite e úlceras gástricas. Quase metade da população mundial está infectada por H. pylori. O regime terapêutico atual contra H. pylori inclui o uso de um inibidor da bomba de prótons associada a dois ou mais antibióticos. No entanto, a eficácia deste regime está diminuindo principalmente devido à resistência aos antibióticos e efeitos colaterais de medicamentos. Este fato resultou no interesse público em outras opções terapêuticas e o papel dos probióticos merece atenção especial a este respeito. OBJETIVO: Este estudo visa avaliar a eficácia do mel-derivado do Lactobacillus rhamnosus na inflamação gástrica e infecção gastrointestinal H. pylori-induzida em camundongos C57Bl/6. MÉTODOS: Vinte e quatro camundongos C57Bl/6 foram divididos aleatoriamente em três grupos de oito camundongos cada. Todos os ratos foram alimentados com suspensão de 1cc contendo 5*1010 UFC/mL de cepas ATCC43504 de H. pylori por 3 dias consecutivos, duas vezes por dia através de gavagem por tubos de polietileno. No final da 4ª semana, a infecção com H. pylori foi confirmada pelo antígeno fecal (ELISA) e após o sacrifício de um rato de cada grupo, o estudo histopatológico confirmou gastrite. Os grupos foram submetidos a diferentes terapias, como indicado, 1: sem prescrição de bismuto (BI), Omeprazol (Om) e L. rhamnosus, 2: Bi, Om e claritromicina (CL) e 3: Bi, Om mais 1cc de suspensão de 109 UFC/mL de L. rhamnosus. Após 2 semanas, as fezes foram analisadas para o antígeno e os ratos foram sacrificados para a avaliação das alterações histopatológicas. RESULTADOS: O tratamento com o grupo L. rhamnosus forneceu o título zero de antígeno e foi associado com a inflamação gástrica melhorada em todos os camundongos, similar ao grupo claritromicina. CONCLUSÃO: O probiótico mel-derivado L. rhamnosus fornece resultados semelhantes ao da claritromicina em termos de melhoria da infecção H. pylori e gastrite em C57Bl/6 camundongos modelos, sem os inconvenientes de resistência aos antibióticos.

Upper gastrointestinal endoscopy applied in pediatrics: endoscopic and histological findings, including Helicobacter pylori / Endoscopia digestiva alta aplicada em pediatria: hallazgos endoscópicos e histológicos incluyendo al Helicobacter pylory

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

Objetivo: Presentar y discutir los hallazgos endoscópicos e histológicos, así como la incidencia de Helicobacter pylori y otras enfermedades, indicaciones y características de endoscopia digestiva alta realizada en niños. Material y métodos: Fueron realizadas 225 endoscopias en niños de seis meses a 11 años (media de 7,69 años) a partir de febrero de 2013 hasta enero de 2016. En 200 pacientes, en las endoscopias diagnósticas se llevan a cabo biopsias seriadas (esófago, estómago y duodeno) en 120 de ellos. Resultados: La indicación de endoscopia fue diagnóstica en el 88,89% de los pacientes y en 26 pacientes se realizaron un procedimiento terapéutico. Los hallazgos endoscópicos más frecuentes fueron esofagitis en 49 pacientes, gastritis y duodenitis 84 y en 16 pacientes se diagnosticaron cuatro úlceras duodenales. En endoscopias terapéuticas fueron realizadas seis gastrostomías, catorce extracciones de cuerpos extraños, cinco pasajes de sonda nasogástrica y una dilatación esofágica. El estudio de H. pylori se realizó por el método histopatológico y fué positivo en 26 (13%) de 200 pacientes en los que se han buscado. Conclusión: La endoscopía pediátrica es un nicho importante de la endoscopía digestiva donde es importante enfatizar la relevancia de la estructura institucional que realiza estos procedimientos para conducirlos con seguridad y ser capaces de tratar las complicaciones posibles

Effects of nonsteroidal anti-inflammatorydrug on prevalence of helicobacter like organisms in gastric mucosa of thoroughbreds horses

The aim of this study was describe effects of NonsteroidalAnti-inflammatory drug on prevalence of Helicobacter LikeOrganisms in gastric mucosa of Thoroughbreds horses. Werestudied 54 Thoroughbred horses in the national race Track“La Rinconada” Caracas-Venezuela. All equine were treatedby seven days with phenylbutazone at an intravenous doseof 4.4 mg/kg. All horses presented Equine gastric ulcer syndromeacute superficial gastritis (25/54), chronic gastritis witherosion focal (16/54), chronic gastritis with erosion focal andulcers (14/54) in the gastric in both regions mucosa squamousregion and glandular regions (fundus). Helicobacter Like Organismsinfection in the stomach was confirmed by Warthin-Starry (38/54). Gastric mucosa revealed numerous spiralshapedbacteria morphologically resembling Helicobacter LikeOrganisms in squamous regions, margo plicatus (20/38) andnumerous spiral-shaped bacteria in fundic glands (18/54). Inconclusion, we detected high presence of Helicobacter LikeOrganisms in the gastric mucosa of Thoroughbred horse’streatment with phenylbutazone.

Gastritis y gastropatías: [revisión] / Gastritis and gastropathies: [review]

Se hace una revisión de los diferentes tipos de gastritis, incluyendo cuadros en los que el edema y eritema puede semejar el cuadro, pero sin la típica reacción inflamatoria que denominamos gastropatías. Se hace una descripción de diversos aspectos epidemiológicos, etiológicos, etiopatogénicos; se desarrolla diversas clasificaciones propuestas y se describe los métodos diagnósticos, tratamientos recomendados y el pronóstico de esta molestia tan común.

A review of the different types of gastritis, including features in which the edema and erythema can resemble the picture, but without the typical inflammatory reaction that is called gastropathy. A description of various epidemiological, aetiological, pathogenetic, are proposed. The review describes the diagnoses and treatment recommendations and prognosis of this common disorder.

Revisión narrativa de la literatura sobre manejo con medicina homeopàtica de pacientes con síntomas de gastritis / Narrative review of the literature on management with homeopathic medicine of patients with symptoms of gastritis

Las enfermedades del aparato digestivo son frecuentes y en ocasiones incapacitantes para la vida diaria y laboral. Dentro de ellas la gastritis es una de las que más incidencia tiene en el mundo entero. En gran parte de los casos la gastritis está acompañada de la infección por Helicobacter Pylori, bacteria que está relacionada con el cáncer de estómago. Los tratamientos que actualmente se llevan a cabo en la medicina tradicional, además de que son muy agresivos, todavía dejan muchas dudas sobre sus efectos secundarios y los daños que pueden llegar a provocar en el organismo, dentro de ellos el cáncer. Por eso mismo se ha visto el incremento en la utilización de las terapias alternativas para el manejo de la gastritis, dentro de ellas la homeopatía, la cual ha tenido una muy buena aceptación y resultados, pero desafortunadamente, todos estos avances no están lo suficientemente documentados. Para la realización de éste trabajo primero se hizo una Revisión Narrativa de la Literatura existente en los últimos 20 años, encontrando en las bases de datos que algunos remedios homeopáticos han demostrado resultados favorables en el manejo de la gastritis y tienen publicaciones muy interesantes en la literatura, pero la gran mayoría de remedios sólo se encuentran relacionados en las materias médicas. Sin embargo, este trabajo logró establecer los medicamentos homeopáticos útiles en la gastritis basándose en los síntomas que reportan las principales Medicinas Internas conocidas, como son las de: Harrison, Cecil y Farreras. Tomando éstos síntomas se pasaron al lenguaje repertorial homeopático, luego se realizó un ejercicio repertorial que nos revela varios remedios policrestos muy valiosos para el manejo de los síntomas de la gastritis. Además se realizó otra repertorización buscando sólo remedios pequeños, que nos pone delante de los ojos, opciones medicamentosas muy útiles que probablemente nunca habríamos pensado. Dentro de los remedios policrestos y semipolicrestos que se encontró tenían la mejor cobertura de síntomas de gastritis están: Arsenicum álbum, Nux vómica, Sulphuricumacidum, Sulphur, Magnesia carbónica, Lycopodium, KaliBichromicum, Iris Versicolor, Graphites, Crocus sativa, Carbovegetabilis, ArgentumNitricum, Bismuthum, Anacardiumorientale, Phosphorus, Plumbummetallicum, Bryonia, NatrumMuriaticum, Lachesis, China officinalis y Pulsatilla. Dentro de los pequeños remedios se encontraron en los primeros 5 lugares: ArsenicumIodatum, Tabacum, SecaleCornutum, FerrumPhosphoricum y Oxalicumacidum; los cuales son incluidos en la tabla de resultados de medicamentos para gastritis, junto con los policrestos y otros remedios de gran valor en el manejo de la gastritis. Este trabajo será de gran ayuda y motivación especialmente para los médicos que trabajamos con la homeopatía, para seguir publicando cada vez con mayor dedicación y detalle con el fin de dar a conocer todas las maravillas que la homeopatía nos demuestra día a día.

Gastritis necrotizante: caso clínico / Necrotizing gastritis: case report

Necrotizing gastritis is an infrequent severe pathology. The rich vascular supply and intramural arterial anastomosis protects stomach from vascular disease and embolism. Gastric infarction and necrosis presents as an acute abdominal emergency that requires rapid resolution, which in general includes surgery. Other important etiologies reported are chemical agents, mechanical distention, postoperative, bulimia and infectious diseases. In this article, we report a case of necrotizing gastritis in a 29 years-old male patient, with chronic consumption of NSAIDs for low back pain. He was admitted in the emergency room due to acute abdominal pain that appeared, after alcohol and raw fish consumption. Antral wall thickening was observed in the abdominal computed tomography. Upper gastric endoscopy showed necrosis of antral mucosa and biopsies confirmed necrotizing gastritis. He received medical therapy with antibiotics and proton pump inhibitors with an excellent response with clinical and endoscopic resolution in one month.

La gastritis necrotizante es una patología infrecuente muy grave. Esto se debe en parte a la rica irrigación y a las anastomosis arteriales intramurales que protegen al estómago de enfermedades vasculares y embolias. El infarto gástrico se presenta como una urgencia abdominal, que requiere resolución precoz, frecuentemente quirúrgica. Otras etiología importantes reportadas incluyen agentes químicos, factores mecánicos, bulimia e infecciones. En este artículo se presenta el caso de un paciente de 29 años, sexo masculino, con antecedentes de uso crónico de anti-inflamatorios no esteroidales (AINES), que ingresa a urgencia con dolor abdominal agudo, posterior al consumo de alcohol y pescado crudo. Destaca un engrosamiento antral marcado, sin neumatosis en la tomografía computada de abdomen. En la endoscopia digestiva alta se observa extensa necrosis de la mucosa antral y se confirma el diagnóstico de gastritis necrotizante por biopsias. El paciente tuvo una excelente respuesta a tratamiento con reposo intestinal, antibióticos e inhibidores de bomba de protones. Luego de 1 mes, presentó recuperación completa clínica y endoscopía.

Capacidad antioxidante de la sangre de grado (Croton palanostigma) sobre la mucosa gástrica, en animales de experimentación / Antioxidant capacity of sangre de grado (Croton palanostigma) on gastric mucosa in experimentation animals

Introducción: El uso de la sangre de grado para el tratamiento de la gastritis y úlceras gástricas se realiza de manera empírica. En investigaciones anteriores hemos observado su capacidad cicatrizante y protectora de la mucosa gástrica, por la estimulación de la secreción de moco, secreción del jugo gástrico sin alterar el pH e incremento de la actividad péptica; por sus componentes, podría además tener capacidad antioxidante, lo que potenciaría su actividad citoprotectora. Objetivo: Determinar la capacidad antioxidante de la sangre de grado (Croton palanostigma) sobre la mucosa gástrica en animales de experimentación, por la prueba de TBARS. Diseño: Estudio prospectivo, analítico-experimental y longitudinal. Lugar: Centro de Investigación de Bioquímica y Nutrición Facultad de Medicina UNMSM. Material biológico: Cuarenta ratas albinas machos, entre 220 a 250 g de peso, distribuidas en 4 grupos. Intervenciones: Previo ayuno sólido de 24 h, se administró a las ratas por canulación orogástrica, en dosis única, del modo siguiente: Grupo basal: glucosa 37,5 kcal/kg de peso. Grupo injuria: alcohol 37,7 kcal/kg en glucosa. Grupo control: alcohol 37,7 kcal/kg con piroxicam 10 mg/kg en glucosa. Grupo experimental: alcohol 37,7 kcal/kg con sangre de grado 0,8 mL/kg, en solución de glucosa. Los animales tuvieron agua para consumo ad libitum. Seis horas después, bajo anestesia con éter vaporizado, se practicó una cirugía abdominal, se extrajo el estómago y se obtuvo la porción glandular, se separó una porción representativa de aproximadamente 0,5 g. El tejido gástrico fue homogenizado con buffer fosfato de sodio 50 mmol/L, a pH 7,4. Se determinó la lipoperoxidación midiendo sustancias reactivas al ácido tiobarbitùrico (TBARS), por método espectrofotométrico a 535 nm y se expresó en nmol/gramo de tejido gástrico. Principales medidas de resultados: Capacidad antioxidante de la sangre de grado (Croton palanostigma) sobre la mucosa gástrica, en animales de experimentación...

Introduction: Sangre de grado use in gastritis and gastric ulcer treatment is done empirically. In previous investigations we have observed sangre de grado both gastric mucosa healing and protection capacity by stimulating mucous secretion, gastric juice secretion without pH change, and increase in peptic activity; due to its components it may have also antioxidant capacity, thus strengthening its citoprotector activity. Objective: To determine sangre de grado (Croton palanostigma) antioxidant capacity on gastric mucosa in experimentation animals by using TBARS test. Design: Prospective, analytic-experimental and longitudinal study. Setting: Biochemistry and Nutrition Research Center, Faculty of Medicine, UNMSM. Biologic material: Forty male albino rats between 200 and 250 g. Interventions: Following 24 hours solid food fasting, the rats received by orogastric cannulation and in unique dose the following: Basal group: glucose 37,5 kcal/kg. Alcohol supplied group: alcohol 37,7 kcal/kg in glucose solution. Control group: alcohol 37,7 kcal/kg with piroxicam 10 mg/kg in glucose solution. Experimental group: alcohol 37,7 kcal/kg plus sangre de grado 0,8 mL/kg in glucose solution. All animals received water ad libitum. Six hours afterwards, abdominal surgery was practiced under vaporized ether anesthesia, the stomachs were extracted and a representative portion of approximately 0,5 g of their glandular portions was obtained. The gastric tissue was homogenized with buffer sodium phosphate 50 mmol/L, at 7,4 pH. Lipoperoxidation was determined by measuring substances...

Gastrite por "helicobacter pylori": quando e como tratar / \"Helicobacter pylori\" gastritis: when and how to treat it

Os autores reconhecem que seria impossível o tratamento com antimicrobianos, visando a cura da gastrite e a erradicaçao do Helicobacter pylori, considerando sua prevalência em mais da metade da populaçao mundial, a maioria assintomática. Apesar da posiçao oficial das sociedades de gastrenterologia, nao recomendando tratamento para os pacientes com dispepsia funcional associada à gastrite por Hp, os autores sugerem que aqueles poderiam ser beneficiados com a terapêutica. Destacam que, mesmo nao existindo evidências de que a gastrite por Hp exerça algum papel na sintomatologia e na fisiopatologia da dispepsia funcional, a cura da infecçao evitaria o risco potencial de desenvolvimento de úlcera péptica e poderia modificar a epidemiologia do câncer e linfoma gástricos. Propoem esquema terapêutico de curta duraçao apenas nos pacientes com sintomatologia exuberante, com gastrite endoscópica grave, presença de Hp na mucosa gástrica e processo inflamatório ativo e intenso à histopatologia. Consideram que ainda há necessidade de observaçoes clínicas mais aprofundadas por meio de estudos controlados.