RESUMO
INTRODUCCIÓN: Helicobacter pylori afecta a más de 50% de la población mundial, siendo más prevalente en poblaciones de nivel socioeconómico bajo; esta bacteria constituye la principal causa de cáncer gástrico a nivel global. OBJETIVO: Determinar la frecuencia y los factores asociados a la infección por H. pylori en personas adultas que viven en el centro histórico de la ciudad de Cajamarca, en el norte del Perú. MATERIAL Y MÉTODO: Estudio descriptivo que incluyó 124 personas encuestadas mediante un cuestionario y evaluadas mediante endoscopía y cultivo de biopsia gástrica. Una biopsia por persona fue sometida a prueba de ureasa y los cultivos se confirmaron por reacción de polimerasa en cadena (RPC). RESULTADOS: La frecuencia de infección fue de 60,5 % (IC 95% 51,3 - 69,2). El análisis univariado demostró asociación significativa entre la infección y la edad (p = 0,002), y entre la infección y el antecedente de patología gástrica (p = 0,015). El análisis multivariado reveló dos factores asociados: edad (OR = 0,94; IC95% 0,90-0,97) y antecedente de infección por H. pylori (OR = 0,23; IC95% 0,08 - 0,67). CONCLUSIONES: Existe alta frecuencia de infección por H. pylori en esta población; la edad y el antecedente de infección constituyen factores asociados que deben evaluarse con mayor profundidad.
BACKGROUND: Helicobacter pylori affects more than 50% of the world's population, being more prevalent in populations of low socioeconomic status. H. pylori is the main cause of gastric cancer globally. AIM: To establish the frequency and factors associated with H. pylori infection in adults living in the historic center of Cajamarca City, in northern Peru. METHODS: This was a descriptive study that included 124 individuals surveyed through a questionnaire and evaluated through endoscopy and gastric biopsy culture. One biopsy per person underwent the urease test, and the cultures were confirmed by PCR. RESULTS: The frequency of infection was 60.5% (95% CI 51.3 - 69.2). In the univariate analysis, there was a significant association between the infection and age (p = 0.002), and between the infection and a history of gastric pathology (p = 0.015). The multivariate analysis revealed two associated factors: age (OR = 0.94; 95% CI 0.90 - 0.97), and history of H. pylori infection (OR = 0.23; 95% CI 0.08 - 0.67). CONCLUSIONS: There is a high frequency of H. pylori infection in this population, and the age and history of H. pylori infection are factors that should be further evaluated.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/epidemiologia , Peru/epidemiologia , Urease/análise , Biópsia , Reação em Cadeia da Polimerase , Estudos Transversais , Análise Multivariada , Inquéritos e Questionários , Fatores de Risco , Endoscopia Gastrointestinal , Helicobacter pylori/isolamento & purificação , Helicobacter pylori/genética , Infecções por Helicobacter/microbiologia , Mucosa Gástrica/microbiologia , Mucosa Gástrica/patologiaRESUMO
BACKGROUND: Helicobacter pylori infection has been reported to lead to post-operative complications after bariatric surgery (BS), especially marginal ulcers. The optimal method for pre-operative screening is yet to be determined. OBJECTIVE: To analyze the diagnostic accuracy of the endoscopic urease test for the detection of H. pylori in individuals undergoing BS and the main endoscopic and histological changes within this population. METHODS: A cross-sectional study was carried out based on a database from medical records of 232 individuals who underwent BS between 2016 and 2019 at a tertiary university hospital. Clinical, anthropometric, and endoscopic data were analyzed. The gold-standard method considered to calculate diagnostic accuracy variables was histopathological examination through hematoxylin-eosin/Giemsa stains. RESULTS: 87.5% of the participants were female; mean age was 38.5±9.5 years and average body mass index was 37.6±3.8 kg/m2. The commonest endoscopic finding was gastritis (50.9%) with a predominance of the mild erosive form (25%). Upon histological examination, 59.1% of the participants had confirmed H. pylori infection. H. pylori infection was associated with higher frequencies of endoscopic duodenitis (23.4% vs 12.6%; P=0.04), histological chronic gastritis (100% vs 56.8%; P<0.0001) and histological acute gastritis (58.4% vs 2.1%; P<0.0001). The urease test had a sensitivity of 79.6% and a specificity of 97.9%, leading to an overall accuracy of 87.1%. CONCLUSION: The endoscopic urease test is highly accurate for pre-operative screening of H. pylori infection in individuals who undergo BS. H. pylori infection was significantly associated with endoscopic (duodenitis) and histopathological (chronic and active gastritis) changes.
Assuntos
Bariatria , Duodenite , Gastrite , Infecções por Helicobacter , Helicobacter pylori , Adulto , Estudos Transversais , Feminino , Gastrite/diagnóstico , Infecções por Helicobacter/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Urease/análiseRESUMO
Objetivo: Analisar a acurácia do teste rápido da urease para detecção de Helicobacter pylori comparado com o exame histopatológico. Métodos: Estudo prospectivo e descritivo realizado de abril de 2018 a maio de 2019 em um Serviço de Endoscopia e Biliopancreática e em um laboratório de patologia. A amostra foi composta de 64 pacientes, de ambos os sexos, com idade de 35 a 81 anos, que apresentavam queixas dispépticas. Foram realizados exame histopatológico e teste rápido da urease. Os dados foram analisados pelo R Core team 2019 e submetidos a análises descritivas (variáveis categóricas) e inferenciais (teste de associação de qui-quadrado de Pearson e teste de Mann-Whitney). O nível de significância adotado foi de 5%. Resultados: O teste rápido da urease demonstrou que dez pacientes foram verdadeiros-positivos, 39 verdadeiros-negativos, três falsos-positivos, 12 falsos-negativos, com sensibilidade de 45,4% (25,1% a 67,3%), especificidade de 92,9% (79,4% a 98,1%), valor preditivo positivo de 76,9% (45,9% a 93,8%), valor preditivo negativo de 76,5% (62,2% a 86,7%), acurácia de 76,6% (64,0% a 85,9%), razão de chance diagnóstica 10,8 (2,56 a 45,9), índice de Youden 0,38 (0,16 a 0,60) e taxa de erro de 23,4% (14,1% a 36,0%). Conclusão: O teste rápido da urease apresentou baixa capacidade de detectar pacientes infectados, menor acurácia em relação ao estudo anatomopatológico e alta especificidade. O teste pode ser útil no momento da realização da endoscopia, por fornecer resultado rápido e barato para detectar H. pylori. O diagnóstico da bactéria apresenta maior confiabilidade com a realização dos dois métodos para pesquisa de H. pylori.
Objective: To analyze the accuracy of the rapid urease test for Helicobacter pylori detection when compared with the histopathological examination. Methods: This is a prospective and descriptive study conducted from April 2018 to May 2019, at an Endoscopy and Biliopancreatic Service and in a pathology laboratory. The sample consisted of 64 male and female patients aged 35 to 81 years old with dyspeptic complaints. Histopathological examination and rapid urease test were performed. Data were analyzed by R Corel team 2019 and underwent descriptive (categorical variables) and inferential (Pearson's Chi-squared association test and Mann-Whitney test) analyzes. The significance level adopted was 5%. Results: The rapid urease test showed that ten patients were true positive, 39 true negative, three false-positive, and 12 false-negative, and sensitivity was of 45.4% (25.1% to 67.3%), specificity 92.9% (79.4% to 98.1), positive predictive value of 76.9% (45.9-93.8%), negative predictive value of 76.5% (62.2% to 86.7%), accuracy of 76.6% (64.0% to 85.9%), diagnostic odds ratio of 10.8 (2.56% to 45.9), Youden index 0.38 (0.38% to 0.60), and error rate 23.4 (14.1% to 36.0%). Conclusion: The rapid urease test showed low ability to detect infected patients, lower accuracy compared to the pathological study, and high specificity. The test may be useful at the time of endoscopy, as it provides a quick and inexpensive result to detect H. pylori. The diagnosis of the bacterium is more reliable when both methods for H. pylori investigation are performed
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Urease/análise , Helicobacter pylori/enzimologia , Infecções por Helicobacter/diagnóstico , Mucosa Gástrica/patologia , Biópsia , Estudos Prospectivos , Sensibilidade e Especificidade , Gastroscopia , Dispepsia/diagnósticoRESUMO
BACKGROUND: It is widely assumed that gender, age, gastritis and Helicobacter pylori , all have some degree of correlation and, therefore, can synergistically lead to the development of gastric cancer. OBJECTIVE: In this cross-sectional study, we expected to observe the above mentioned correlation in the analysis of medical records of 67 patients of both sexes (female, n=44), mean age ± standard deviation: 41±12 years old, all from Belém (capital of Pará State, Brazilian Amazon), a city historically known as one with the highest gastric cancer prevalence in this country. METHODS: All patients were submitted to upper gastrointestinal endoscopy for gastric biopsy histopathological analysis and rapid urease test. All diagnoses of gastritis were recorded considering its topography, category and the degree of inflammatory activity, being associated or not associated with H. pylori infection. RESULTS: The results show that no statistically relevant associations were found among the prevalences of the observed variables. CONCLUSION: The authors hypothesize that observed risk factors associated to gastric cancer might be lesser synergistic than is usually expected.
Assuntos
Mucosa Gástrica/microbiologia , Gastrite/microbiologia , Infecções por Helicobacter/complicações , Neoplasias Gástricas/microbiologia , Urease/análise , Adulto , Fatores Etários , Biópsia , Brasil/epidemiologia , Estudos Transversais , Endoscopia do Sistema Digestório , Feminino , Mucosa Gástrica/patologia , Gastrite/patologia , Infecções por Helicobacter/enzimologia , Infecções por Helicobacter/epidemiologia , Helicobacter pylori , Humanos , Mucosa Intestinal/enzimologia , Masculino , Pessoa de Meia-Idade , Prevalência , Distribuição por Sexo , Fatores Sexuais , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/patologiaRESUMO
ABSTRACT BACKGROUND: It is widely assumed that gender, age, gastritis and Helicobacter pylori , all have some degree of correlation and, therefore, can synergistically lead to the development of gastric cancer. OBJECTIVE: In this cross-sectional study, we expected to observe the above mentioned correlation in the analysis of medical records of 67 patients of both sexes (female, n=44), mean age ± standard deviation: 41±12 years old, all from Belém (capital of Pará State, Brazilian Amazon), a city historically known as one with the highest gastric cancer prevalence in this country. METHODS: All patients were submitted to upper gastrointestinal endoscopy for gastric biopsy histopathological analysis and rapid urease test. All diagnoses of gastritis were recorded considering its topography, category and the degree of inflammatory activity, being associated or not associated with H. pylori infection. RESULTS: The results show that no statistically relevant associations were found among the prevalences of the observed variables. CONCLUSION: The authors hypothesize that observed risk factors associated to gastric cancer might be lesser synergistic than is usually expected.
RESUMO CONTEXTO: É amplamente assumido que gênero, idade, gastrite e Helicobacter pylori , todos têm algum grau de correlação e, portanto, podem sinergicamente levar ao desenvolvimento de câncer gástrico. OBJETIVO: Neste estudo transversal, esperamos observar a correlação acima mencionada na análise de prontuários de 67 pacientes de ambos os sexos (sexo feminino, n=44), média de idade ± desvio padrão: 41±12 anos, todos de Belém (capital do Estado do Pará, Amazônia Brasileira), uma cidade historicamente conhecida como sendo uma das que apresenta maior prevalência de câncer gástrico no país. MÉTODOS: Todos os pacientes foram submetidos à endoscopia digestiva alta para análise histopatológica da biópsia gástrica e teste rápido da urease. Todos os diagnósticos de gastrite foram registrados considerando sua topografia, categoria e grau de atividade inflamatória, sendo associada ou não associada à infecção por H. pylori . RESULTADOS: Os resultados mostram que não foram encontradas associações estatisticamente relevantes entre as prevalências das variáveis observadas. CONCLUSÃO: Os autores levantam a hipótese de que os fatores de risco associados ao câncer gástrico podem ser menos sinérgicos do que o esperado.
Assuntos
Humanos , Masculino , Feminino , Adulto , Neoplasias Gástricas/microbiologia , Urease/análise , Infecções por Helicobacter/complicações , Mucosa Gástrica/microbiologia , Mucosa Gástrica/patologia , Neoplasias Gástricas/patologia , Neoplasias Gástricas/epidemiologia , Biópsia , Brasil/epidemiologia , Fatores Sexuais , Prevalência , Estudos Transversais , Endoscopia do Sistema Digestório , Helicobacter pylori , Infecções por Helicobacter/enzimologia , Infecções por Helicobacter/epidemiologia , Fatores Etários , Distribuição por Sexo , Gastrite/microbiologia , Gastrite/patologia , Mucosa Intestinal/enzimologia , Pessoa de Meia-IdadeRESUMO
INTRODUCTION: The presence of H. pylori in the stomach is associated with gastric pathologies. However, its diagnosis through culture methods is challenging because of its complex nutritional requirements and microaerophilic conditions for optimal growth. The preferred method for rapid diagnosis of H. pylori is the Rapid Urease Test (RUT) from human biopsies, which relies on the high activity of the urease enzyme present in H. pylori. However, RUT cannot say much more information about H. pylori. This makes evident the need for bacterial culture to know essential information such as the strain type, the kind of infection present and the bacteria's antibiotic susceptibility. METHODOLOGY: Gastric biopsies from 347 patients were used for H. pylori isolation. We correlated the culture results with the RUT and histological grading used at Hospital Universitario Fundación SantaFe de Bogotá (HU-FSFB), Colombia. The concordance between techniques was determined by the Cohen's Kappa coefficient (K). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were also calculated. RESULTS: The culture standardization was successful, and it could be applied for diagnosis in the clinical practice. H. pylori was positive by culture in 88 (26.34%) patients. The concordance of RUT and culture was strong (K= 0.805), and between histology and culture was moderate (K= 0.763) as well as for the gold standard defined and culture (K= 0.80). CONCLUSIONS: We present evidence that RUT and histological methods will be better interpreted for diagnosis of H. pylori if combined with bacterial isolation in cholesterol enriched culture.
Assuntos
Técnicas Bacteriológicas/métodos , Testes Diagnósticos de Rotina/métodos , Infecções por Helicobacter/diagnóstico , Helicobacter pylori/crescimento & desenvolvimento , Helicobacter pylori/isolamento & purificação , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Testes Respiratórios , Colômbia , Feminino , Mucosa Gástrica/microbiologia , Histocitoquímica , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Urease/análise , Adulto JovemRESUMO
Na região amazônica, ainda que não conclusivo, estima-se a existência de aproximadamente 60.000 espécies de plantas contribuindo para uma vasta riqueza natural. Considerando essa estimativa, são necessários investimentos em ciência e tecnologia, proteção e valorização dos recursos naturais e, principalmente, a importância dos conhecimentos tradicionais associados à biodiversidade (Albagli, 2010). O conhecimento tradicional tem fornecido informações valiosas para a descoberta de novos agentes antimicrobianos a partir das plantas (Duraipandiyan, Ayyanar e Ignacimuthu, 2006), destacando a importância da medicina popular na busca por moléculas eficazes contra micro-organismos cada vez mais resistentes (Lopez, Hudson e Towers, 2001), como por exemplo Helicobacter pylori.(AU)
The Amazon region has an enormous diversity of plant species, which contributes to its known vast natural wealth. In this context, the aim of this work was to evaluate the antioxidant, anti-Helicobacter pylori and antiurease potentials of medicinal plant extracts popularly used in the western Pará, northern Brazil. Antimicrobial assays were carried out using spectrophotometric broth microdilution technique, the antioxidant potential by the DPPH and ABTSâ¢+ assays and anti-urease activity by inhibition of the enzyme urease. The ethanolic extract of leaves of Schnella sp. showed the best antioxidant potential in both methods, with IC50= 6.35 µg/mL (DPPH) and 1.81 µg/mL (ABTSâ¢+) and the highest percentage of inhibition of urease (45%) at 1024 µg/ml. The ethanolic extract of the resin of "breu-branco" inhibited 82.8% (512 µg/mL) of the bacterial growth. These results together show the potential of the plant species used in the western Pará, in the search for molecules with antioxidant and antimicrobial action.(AU)
Assuntos
Humanos , Anti-Infecciosos/química , Antioxidantes/química , Fabaceae/química , Fitoterapia , Plantas Medicinais/química , Ecossistema Amazônico , Brasil , Helicobacter pylori , Urease/análiseRESUMO
Helicobacter spp. is a spiral Gram-negative bacterium that has substantial clinical importance. It has been related to diseases such as gastritis and peptic ulcers, and more recently to gastric cancer in humans. Evidence suggests the potential of animals, particularly domestic ones, as the source of zoonotic infection of helicobacteria since bacteria with similar morphology to those found in animals were observed in the stomach of humans with gastritis. Thus, dogs have been identified to serve as an important host for infectious agents such as Helicobacter spp. From this perspective, the present study aimed to assess the prevalence of Helicobacter spp. in dogs from the Zoonosis Control Center of Campo Grande-MS. Samples of body, fundus, and gastric antrum from 96 dogs were collected to evaluate the presence of Helicobacter spp. through the rapid urease test and histological analysis. Helicobacter spp. was found in 94.7% of the dogs by rapid urease test and in 100% by histological analysis, with bacteria predominance in the stomach fundus region.
A Helicobacter spp. é uma bactéria Gram negativa espiralada, de grande importância clínica, que se relaciona a patogenias como gastrite e úlceras pépticas e, mais recentemente, com o carcinoma gástrico em humanos. Evidências sugerem o potencial dos animais, principalmente os domésticos, como fonte de infecção zoonótica das helicobactérias, já que bactérias com morfologia similar às encontradas em animais foram observadas no estômago de humanos com gastrite. Nesse contexto, os cães podem ser um importante reservatório de agentes infecciosos como a Helicobacter spp. O presente trabalho teve como objetivo avaliar a prevalência de Helicobacter spp. em cães do Centro de Controle de Zoonoses de Campo Grande/MS. Para tanto, foram utilizados 96 cães dos quais foram colhidas amostras do corpo, fundo e antro gástrico, para avaliação da presença da Helicobacter spp. por meio do teste rápido de urease e análise histológica. O teste rápido de urease permitiu a detecção deHelicobacter spp. em 94,7% dos cães; já a análise histológica indicou a presença de Helicobacter spp. em 100% dos animais avaliados com predomínio da bactéria na região do fundo do estômago.
Assuntos
Animais , Helicobacter/patogenicidade , Prevalência , Bactérias Gram-Negativas/patogenicidade , Estudos Transversais , Urease/análiseRESUMO
Helicobacter spp. is a spiral Gram-negative bacterium that has substantial clinical importance. It has been related to diseases such as gastritis and peptic ulcers, and more recently to gastric cancer in humans. Evidence suggests the potential of animals, particularly domestic ones, as the source of zoonotic infection of helicobacteria since bacteria with similar morphology to those found in animals were observed in the stomach of humans with gastritis. Thus, dogs have been identified to serve as an important host for infectious agents such as Helicobacter spp. From this perspective, the present study aimed to assess the prevalence of Helicobacter spp. in dogs from the Zoonosis Control Center of Campo Grande-MS. Samples of body, fundus, and gastric antrum from 96 dogs were collected to evaluate the presence of Helicobacter spp. through the rapid urease test and histological analysis. Helicobacter spp. was found in 94.7% of the dogs by rapid urease test and in 100% by histological analysis, with bacteria predominance in the stomach fundus region.(AU)
A Helicobacter spp. é uma bactéria Gram negativa espiralada, de grande importância clínica, que se relaciona a patogenias como gastrite e úlceras pépticas e, mais recentemente, com o carcinoma gástrico em humanos. Evidências sugerem o potencial dos animais, principalmente os domésticos, como fonte de infecção zoonótica das helicobactérias, já que bactérias com morfologia similar às encontradas em animais foram observadas no estômago de humanos com gastrite. Nesse contexto, os cães podem ser um importante reservatório de agentes infecciosos como a Helicobacter spp. O presente trabalho teve como objetivo avaliar a prevalência de Helicobacter spp. em cães do Centro de Controle de Zoonoses de Campo Grande/MS. Para tanto, foram utilizados 96 cães dos quais foram colhidas amostras do corpo, fundo e antro gástrico, para avaliação da presença da Helicobacter spp. por meio do teste rápido de urease e análise histológica. O teste rápido de urease permitiu a detecção deHelicobacter spp. em 94,7% dos cães; já a análise histológica indicou a presença de Helicobacter spp. em 100% dos animais avaliados com predomínio da bactéria na região do fundo do estômago.(AU)
Assuntos
Animais , Helicobacter/patogenicidade , Prevalência , Urease/análise , Bactérias Gram-Negativas/patogenicidade , Estudos TransversaisRESUMO
Abstract Tinea faciei is a relatively uncommon dermatophyte infection entailing atypical clinical symptoms, usually misdiagnosed and treated with corticosteroids. The authors describe a case of tinea faciei on the right eyebrow caused by Trichophyton interdigitale. The patient was an 18-year-old girl, who had an inflammatory plaque with a scaly, pustular surface on the right eyebrow and upper eyelid, which had persisted for over 1 month. She was once misdiagnosed as having eczema and was treated using corticosteroid cream. A diagnosis of tinea faciei was made based on direct microscopy and culture. The sequencing of the nuclear ribosomal ITS region and β-tubulin gene of the isolate established its T. interdigitale lineage. The patient was cured by treatment with systemic terbinafine in combination with topical application of 1% naftifine-0.25% ketaconazole cream for 2 weeks.