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- ItemAcesso aberto (Open Access)Alterações no teste ultra-rápido da urease e no exame anatomopatológico para Helicobacter pylori induzidas por drogas anti-secretoras(Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED, 2001-01-01) Ferreira, Lincoln Eduardo Villela Vieira de Castro; Meirelles, Gustavo de Souza Portes [UNIFESP]; Vieira, Renata La Rocca; Bragagnolo Junior, Maurício Augusto; Chebli, Julio Maria Fonseca [UNIFESP]; Souza, Aécio Flávio Meirelles de; Universidade Federal de Juiz de Fora Serviço de Gastroenterologia Setor de Endoscopia Digestiva; Universidade Federal de São Paulo (UNIFESP); Universidade Federal de Juiz de Fora; Universidade Federal de Juiz de Fora Hospital Universitário Gastroenterologia Clínica; Universidade Federal de Juiz de Fora Faculdade de Medicina Disciplina de Gastroenterologia; Universidade Federal de Juiz de Fora Hospital Universitário Serviço de Gastroenterologia; Universidade Federal de Juiz de Fora Núcleo de Estudos e Pesquisas em Gastroenterologia e Endoscopia DigestivaBackground - One of the major problems when evaluating dyspeptic patients at public hospitals is the large interval between the consultation and the endoscopy, leading to the prescription of antisecretory drugs, what can be responsible for false results on examinations. Aim - To evaluate changes in ultrarapid urease test and histopathological examination for Helicobacter pylori by antisecretory drugs. Methods - In a prospective double-blind study, 50 patients with dyspeptic complaints and endoscopic diagnosis of peptic ulcer, erosive gastritis, esophagitis or duodenitis, with a positive urease test, were randomized to a 7-day course of treatment with either omeprazole 20 mg or ranitidine 300 mg a day. Before and after treatment, two biopsy specimens each were obtained from the antrum and corpus and an ultrarapid urease test and a histopathological examination for Helicobacter pylori were performed. Results - There were no significant changes in the results of ultrarapid urease test and histopathological examination for Helicobacter pylori after treatment with ranitidine. With omeprazole, we observed a decrease in positive results in ultrarapid urease test and histopathological examination for Helicobacter pylori in the antrum, but not in the corpus. Conclusion - Omeprazole, used for 7 days, can lead to negative results in ultrarapid urease test and histopathological examination for Helicobacter pylori in the antrum, and should not be employed in patients before the endoscopy is performed.
- ItemAcesso aberto (Open Access)Análise da resistência antimicrobiana e do genótipo de Helicobacter pylori em pacientes pediátrica da cidade de São Paulo(Universidade Federal de São Paulo (UNIFESP), 2011-04-27) Garcia, Gabriella Teixeira [UNIFESP]; Scaletsky, Isabel Cristina Affonso [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Helicobacter pylori é o principal agente de gastrite e fator de risco para úlcera péptica e câncer gástrico. A evolução da infecção está relacionada a diversos fatores bacterianos, incluindo cagA, vacA e iceA. A infecção ocorre geralmente na infância e persiste pela vida, ao menos que tratado com terapia antibacteriana. No entanto, a resistência aos antibióticos é a principal causa do fracasso do tratamento. O objetivo deste estudo foi analisar a resistência antimicrobiana e o genótipo de H. pylori em 217 crianças encaminhadas, entre 2008 e 2009, ao Setor de Endoscopia do Instituto da Criança da Faculdade de Medicina da Universidade de São Paulo, para esclarecimento de manifestações clínicas relativas ao trato digestivo alto. Fragmentos de mucosa gástrica foram obtidos por endoscopia e processados para exame histológico, teste da urease e cultura bacteriana. Resistência aos antibióticos foi determinada pelo método da difusão em disco, e os MICs foram determinados por E-test. As mutações pontuais A2142G ou A2143G que conferem resistência a claritromicina foram pesquisadas por PCR-RFLP com as enzimas de restrição BsaI e MboII. Os genótipos vacA, cagA, iceA e babA2 foram detectados por PCR a partir das amostras de biópsias gástricas. H. pylori foi isolado em 45 (20,7%) das 217 crianças estudadas, sendo 13 com gastrite crônica leve, 28 com gastrite crônica moderada, 2 com gastrite crônica intensa e 2 com mucosa normal. Resistência à claritromicina, metronidazol, amoxicilina e tetraciclina foi detectada em 27%, 13%, 4% e 0% das amostras, respectivamente. A PCR-RFLP detectou 12 (26,7%) amostras de H. pylori com genótipo resistente, sendo 8 amostras com mutação A2143G e 4 com mutação A2142G. O gene vacA foi detectado em todas as 45 amostras positivas para H. pylori, sendo os alelos vacAs1m1, vacAs2m2, vacAs1m2 ou vacAs2m1 encontrados em 57,7%, 33,3%, 4,4% e 4,4% das amostras, respectivamente. Os alelos iceA1 e iceA2 foram detectados em 9 (20%) e 31 (68,9%) amostras, respectivamente. Das 45 amostras, 28 (62%) foram positivas para cagA e 38 (84,4%) para babA2. O genótipo vacA s1m1 cagA iceA2 foi encontrado significantemente mais frequentemente nos pacientes com gastrite crônica moderada e intensa (77%) do que em pacientes com gastrite leve (23%) (P < 0,001). Em adição, foi observada associação significativa entre a resistência a claritromicina e o genótipo vacA s1m1 (P = 0,007) ou iceA2 (P = 0,038).
- ItemAcesso aberto (Open Access)Antimicrobial susceptibility testing for Helicobacter pylori isolates from Brazilian children and adolescents: comparing agar dilution, E-test, and disk diffusion(Sociedade Brasileira de Microbiologia, 2014-12-01) Ogata, Silvio Kazuo [UNIFESP]; Gales, Ana Cristina [UNIFESP]; Kawakami, Elisabete [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Antimicrobial susceptibility testing for Helicobacter pylori is increasingly important due to resistance to the most used antimicrobials agents. Only agar dilution method is approved by CLSI, but it is difficult to perform routinely. We evaluated the reliability of E-test and disk diffusion comparing to agar dilution method on Helicobacter pylori antimicrobial susceptibility testing. Susceptibility testing was performed for amoxicillin, clarithromycin, furazolidone, metronidazole and tetracycline using E-test, disk-diffusion and agar dilution method in 77 consecutive Helicobacter pylori strains from dyspeptic children and adolescents. Resistance rates were: amoxicillin - 10.4%, 9% and 68.8%; clarithromycin - 19.5%, 20.8%, 36.3%; metronidazole - 40.2%33.7%, 38.9%, respectively by agar dilution, E-test and disk diffusion method. Furazolidone and tetracycline showed no resistance rates. Metronidazole presented strong correlation to E-test (r = 0.7992, p < 0.0001) and disk diffusion method (r=-0.6962, p < 0.0001). Clarithromycin presented moderate correlation to E-test (r = 0.6369, p < 0.0001) and disk diffusion method (r=-0.5656, p < 0.0001). Amoxicillin presented weak correlation to E-test (r = 0.3565, p = 0.0015) and disk diffusion (r=-0.3565, p = 0.0015). Tetracycline presented weak correlation with E-test (r = 0.2346, p = 0.04) and furazolidone to disk diffusion (r=-0.0288, p = 0.8038). E-test presented better agreement with gold standard. It is an easy and reliable method for Helicobacter pylori susceptibility testing. Disk diffusion method presented high disagreement and high rates of major errors.
- ItemSomente MetadadadosApplication of Real-Time PCR Stool Assay for Helicobacter pylori Detection and Clarithromycin Susceptibility Testing in Brazilian Children(Wiley-Blackwell, 2011-08-01) Scaletsky, Isabel C. A. [UNIFESP]; Aranda, Katia R. S. [UNIFESP]; Garcia, Gabriela T. [UNIFESP]; Goncalves, Manoel E. P.; Cardoso, Silvia R.; Iriya, Kiyoshi; Silva, Neusa P. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)Background: Helicobacter pylori ClariRes assay is a novel commercially available real-time PCR assay allowing H. pylori detection and clarithromycin susceptibility testing in either gastric biopsy or stool specimens.Objective: the aim of this study was to validate the novel biprobe real-time assay in stool specimens from 217 dyspeptic children.Methods: DNA from gastric biopsies and stool specimens were obtained and submitted to the biprobe real time assay for H. pylori detection and clarithromycin susceptibility testing.Results: the sensitivity, specificity, and test accuracy were 69, 100 and 93.9% for the detection of H. pylori infection and 83.3, 100 and 95.6%, for detection of clarithromycin resistance.Conclusion: This assay proved to be appropriate for H. pylori clarithromycin susceptibility testing, particularly in children populations where a high prevalence of clarithromycin-resistant strains is suspected.
- ItemAcesso aberto (Open Access)Aspectos clínicos e histológicos da úlcera duodenal em crianças e adolescentes(Sociedade Brasileira de Pediatria, 2004-08-01) Kawakami, Elisabete [UNIFESP]; Machado, Rodrigo S. [UNIFESP]; Fonseca, Jacqueline A. [UNIFESP]; Patricio, Francy Reis da Silva [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To evaluate clinical and histological features of duodenal ulcer in children and adolescents. METHODS: Forty-three children with duodenal ulcer were prospectively and consecutively evaluated in a 6-year period (7.2 patients per year). Evaluation included clinical questionnaire focused on dyspeptic symptoms, physical examination, and digestive endoscopy with gastric biopsies for histological examination and Helicobacter pylori detection. RESULTS: Diagnostic age ranged from 4 years and 8 months to 17 years and 4 months (mean age: 12 years and 4 months). Abdominal pain was the main symptom (39/43, 90.7%), which was epigastric in 31/39, periumbilical in 7/39, and nocturnal in 27/39. Other symptoms were loss of appetite (32/43, 74.4%), vomiting (30/43, 69.8%), postprandial fullness (23/43, 53.5%), weight loss (22/43, 51.2%), and abdominal tenderness (19/43, 44.2%). Upper gastrointestinal bleeding occurred in 19/43 (44.2%), whereas anemia occurred in (21/43, 48.8%). Helicobacter pylori infection was detected in 41/43 (95.3%). All infected patients presented acute chronic gastritis in antrum, with lymphomononuclear infiltrate predominance in 92% of them. Eradication of the bacterium occurred in 68.3%. Ulcer healing occurred in all eradicated patients and in 89% of non-eradicated patients. CONCLUSION: Duodenal ulcer was associated with chronic gastritis due to Helicobacter pylori in the majority of patients. Many complications occurred, especially upper digestive bleeding.
- ItemSomente MetadadadosASPECTS OF HELICOBACTER PYLORI INFECTION ON THE RESULTS OF BARIATRIC SURGERY.(Springer, 2016) Silva, F. A. F.; Miguel, G. P. S.; Souza, P. H. O.; Fraga, L. C.; Lourenco, R. A.; Gravel, C.; Vecci, T. R. S.; Azevedo, J. L. M. C. [UNIFESP]
- ItemSomente MetadadadosAssessing the therapeutic use of Lafoensia pacari St. Hil. Extract (Mangava-Brava) in the eradication of Helicobacter pylori: Double-blind randomized clinical trial(Blackwell Publishing, 2006-06-01) Menezes, Valfredo da Mota [UNIFESP]; Atallah, Álvaro Nagib [UNIFESP]; Lapa, Antonio José [UNIFESP]; Catapani, Wilson Roberto [UNIFESP]; Univ Fed Mato Grosso; Universidade Federal de São Paulo (UNIFESP)Background: The eradication of Helicobacter pylori is easily achieved by combining antisecretory agents and antibiotics; however, the cost of these associations is very high for the population of Third World countries, where the prevalence of the infection is even higher and leads to markedly reduced treatment effectiveness. We tested a plant (Lafoensia pacari) that is used in the central region of Brazil. According to previous studies, this plant has high concentrations of ellagic acid, which presents gastric antisecretory and antibacterial actions.One hundred dyspeptic, urease-positive patients were randomized to receive 500 mg of methanolic extract of L. pacari (n = 55) or placebo (n = 45), for 14 days, in a double-blind clinical trial. The main variables assessed were the eradication of H. pylori 8 weeks after the intervention and complete symptom relief at the end of the treatment.The examinations (urease and histology) showed persistence of H. pylori in 100% of participants. Complete symptom relief was experienced by 42.5% of patients (95% CI: 29.4-55.8) in the intervention group and by 21% (95% CI: 8.8-33.1) in the control group, p = .020. The side-effects were minimal and similar in both groups.The extract of L. pacari as a single agent was not effective to eradicate H. pylori. However, it was well tolerated and many participants reported relief of symptoms. Future studies may test the agent using larger doses and longer periods, in monotherapy or in combination with antibiotics.
- ItemAcesso aberto (Open Access)Avaliação da eficácia do tratamento do Helicobacter pylori com amoxicilina, claritromicina e lanzoprazol em doentes gastrectomizados por adenocarcinoma gástrico(Universidade Federal de São Paulo (UNIFESP), 2006) Bertoli Neto, Jose Luiz [UNIFESP]; Lourenço, Laércio Gomes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objetivo: Determinar a eficácia da erradicação do Helicobacter pylori em doentes gastrectomizados por adenocarcinoma gástrico em comparação com doentes não gastrectomizados, com o mesmo esquema tríplice. Métodos: Vinte doentes gastrectomizados por adenocarcinoma gástrico com reconstrução em Y de Roux, infectados por Helicobacter pylori foram comparados com um grupo controle de quarenta doentes não gastrectomizados também infectados. A presença do Helicobacter pylori foi determinada pelo teste ultra-rápido da urease e histologia em material colhido por endoscopia. Ambos os grupos receberam o mesmo tratamento tríplice. Resultados: A taxa de erradicação do Helicobacter pylori no grupo de estudo foi de 90% e no grupo controle foi de 85%. O sexo, a idade e o tempo de pós-operatório não influenciaram na taxa de erradicação. Conclusões: Não houve diferença estatística na eficácia da erradicação entre os dois grupos, portanto, o tratamento tríplice é eficaz na erradicação do Helicobacter pylori em doentes gastrectomizados à Y de Roux.
- ItemSomente MetadadadosAvaliação do efeito da infecção por Helicobacter pylori na expressão das citocinas pró-inflamatórias IL-1ß, IL-8 e COX-2(Universidade Federal de São Paulo (UNIFESP), 2010) Bartchewsky Junior, Waldemar [UNIFESP]; Scaletsky, Isabel Cristina Affonso [UNIFESP]
- ItemAcesso aberto (Open Access)Avaliação do efeito da infecção por Helicobacter pylori na expressão das citocinas pró-inflamatórias IL-1β, IL-8 e COX-2(Universidade Federal de São Paulo (UNIFESP), 2010-07-28) Bartchewsky Júnior, Waldemar [UNIFESP]; Scaletsky, Isabel Cristina Affonso [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The infection caused by Helicobacter pylori has been considered as one of the most common chronic bacterial infections in humans. The infection causes an inflammatory response that is followed by an increase in the production of cytokines. Thus, the aim of this study was to evaluate the effects of infection by H. pylori upon gene expression of pro-inflammatory cytokines IL-1b, IL-8 and COX-2 in children H. pylori-positive and negative as well as in adult H. pylori-positive and negative chronic gastritis and gastric cancer patients. The study included 344 patients, divided into five groups: (1) 29 children with H. pylori positive, (2) 98 children with H. pylori negative, (3) 127 adult H. pylori positive, (4) 26 adult H. pylori negative and (5) 64 patients with gastric cancer. Our data indicate that the infection is related to a risk of developing gastric cancer (OR = 4.21, 95% CI = 1.41 ≤ m ≤ 12:55, r = 0.01). Regarding the virulence factors vacA, iceA and babA in children, we did not observe the prevalence of any of the factors studied in this sample. However, it was observed an increase on infection with cagA- strains among this population. Moreover, in adults it was found that infection by more virulent strains (cagA + / vacAs1m1) is a risk factor for developing gastric cancer. By analyzing the expression of pro-inflammatory cytokines IL-1β, IL-8 and COX-2, the data shown in this study showed no differences in the expression of these regardless of the presence of bacteria. Moreover, in adults with chronic gastritis, there was a significant increase in the expression of these genes, and furthermore, these values are even higher in patients infected with cagA-positive strains, vacA s1m1. In patients with gastric cancer was a significant reduction of IL-1β and IL-8, probably due to low bacterial density in biopsies derived from these patients. For COX-2 has not detected a reduction in mRNA levels in these patients.
- ItemSomente MetadadadosAvaliação do fator ambiental na prevalência de Helicobacter pylori(Hp) em crianças de 6 meses a 10 anos: estudo em Marília e Bastos, SP(Universidade Federal de São Paulo (UNIFESP), 2001) Carvalho, Sebastiao Marcos Ribeiro de [UNIFESP]; Atallah, Álvaro Nagib [UNIFESP]
- ItemSomente MetadadadosAvaliação do método imunoenzimatico(ELISA)para diagnóstico da infecção por Helicobacter pylori em crianças e adolescentes(Universidade Federal de São Paulo (UNIFESP), 2000) Miranda, Áurea Cristina Portorreal [UNIFESP]; Kawakami, Elisabete [UNIFESP]A infeccao por Helicobacter pylori (Hp) e reconhecida como a causa mais frequente de gastrite cronica em adultos e criancas. O seu diagnostico e realizado com metodos invasivos em fragmentos de mucosa gastrica obtidos com pinca endoscopica e os metodos nao invasivos. O metodo imunoenzimatico constitui exame simples, rapido e de baixo custo apresentando alta sensibilidade em pacientes adultos. O objetivo do estudo foi avaliar o metodo ELISA para o diagnostico da infeccao por Hp em criancas e adolescentes. Considerou-se Hp positivo quando o teste rapido da urease (TRU) e a histologia (H) foram ambos positivos ou quando a cultura (C) foi positiva e Hp negativo quando todos os testes foram negativos. Foram estudados 111pacientes , com idade compreendida entre 3 meses e 16 anos, (media= 8a 7m n4.0; M= 9 a 5m)sendo 45 por cento do sexo masculino e 55 por cento do sexo feminino. Infeccao por Hp foi diagnosticada em 47.7 por cento (52/111). A sensibilidade da sorologia foi de 83 por cento e 86 por cento e a especificidade foi de 70.6 por cento e 71 por cento, utilizando o ponto de corte de 7 U/ml e 5 U/ml respectivamente. Em pacientes maiores de 10 anos de idade, a sensibilidade foi de 90.6 por cento e 96.8 por cento e a especificidade foi de 71.0 por cento e 61.9 por cento, com ponto de corte de 7 U/ml e 5 U/ml respectivamente. Quando foi utilizada somente a cultura positiva como padrao ouro e ponto de corte em 5 U/ml, a sensibilidade foi de 93.3 por cento, Conclui-se que o metodo ELISA apresentou boa sensibilidade em criancas maiores de 10 anos, utilizando o ponto de corte de 5 U/ml, porem a especificidade foi baixa
- ItemAcesso aberto (Open Access)Avaliação do teste rápido da urease conservado em geladeira(Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED, 2000-07-01) Ornellas, Laura Cotta [UNIFESP]; Cury, Marcelo de Souza [UNIFESP]; Lima, Vinícius Machado de [UNIFESP]; Ferrari, Angelo Paulo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The rapid urease test is an accurate and cheap method, which results are readily available, and broadly used for routine Helicobacter pylori infection diagnosis. Aim - The evaluation of rapid urease test stored in refrigerator at 4 °C (SRUT) compared to regular rapid urease test. Patients and Method - Endoscopic biopsies were obtained from gastric antrum in 104 consecutive patients. Diagnosis of Helicobacter pylori infection was accomplished by rapid urease test, histology and rapid urease test stored (kept in refrigerator by a period ranging from 1 to 8 days). Results - Infection was considered present if both rapid urease test and histology were positive. Helicobacter pylori was present in 45/104 patients (42%). Rapid urease test stored had specificity comparable to rapid urease test (93%), with sensitivity of 88%. Conclusion - We concluded that rapid urease test can be stored in refrigerator for up to 1 week, without loss of clinical applicability, and that can make the test even easier to use for routine Helicobacter pylori tests in a busy endoscopy unit.
- ItemAcesso aberto (Open Access)Avaliação do uso terapêutico do extrato de Lafoensia pacari St. Hil. Mangava-Brava na erradicação do Helicobacter pylori: Ensaio Clínico Randomizado Duplo Cego(Universidade Federal de São Paulo (UNIFESP), 2006-04-03) Menezes, Valfredo da Mota [UNIFESP]; Atallah, Álvaro Nagib [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Background: The eradication of Helicobacter pylori is easily achieved by combining antisecretory agents and antibiotics; however, the cost of these associations is very high for the population of Third World countries, where the prevalence of the infection is even higher and leads to markedly reduced treatment effectiveness. We tested a plant (Lafoensia pacari) that is used in the central region of Brazil. According to previous studies, this plant has high concentrations of ellagic acid, which presents gastric antisecretory and antibacterial actions. Material and Methods: 100 dyspeptic, urease-positive patients were randomized to receive 500mg of methanolic extract of L. pacari (n= 55) or placebo (n= 45), for 14 days, in a double-blind clinical trial. The main variables assessed were the eradication of H. pylori eight weeks after the intervention and complete symptom relief at the end of the treatment. Results: The exams (urease and histology) showed persistence of H. pylori in 100% of participants. Complete symptom relief was experienced by 42.5% of patients (95% CI: 29.4-55.8) in the intervention group and by 21% (95% CI: 8.8-33.1) in the control group, p=0.020. The side effects were minimum and similar in both groups. Conclusions: The extract of L. pacari as a single agent was not effective to eradicate H. pylori. However, it was well tolerated and many participants reported relief of symptoms. Future studies may test the agent using larger doses and longer periods, in monotherapy or in combination with antibiotics.
- ItemSomente MetadadadosAvaliação do uso terapêutico do extrato Lafoensia pacari st. Hil Mangava brava na erradicação do Helicobacter pylori: ensaio clínico randomizado duplo cego(Universidade Federal de São Paulo (UNIFESP), 2002) Menezes, Valfredo da Mota [UNIFESP]; Atallah, Álvaro Nagib [UNIFESP]Objetivos Avaliar a acao de uma substancia usada popularmente como fitoterapico, conhecida cientificamente como Lafoensia pacari, na erradicacao do Helicobacter pylori e verificar se a mesma e mais efetiva que o Placebo para essa erradicacao Metodo: Ensaio Clinico Randomizado Duplo Cego que sera realizado em pacientes adultos, de atendimento ambulatorial em Hospitais Publicos das cidades de São Paulo e Cuiaba, portadores de infeccao pelo Helicobacter pylori, com formacao de dois grupos, um dos quais recebera a substancia a ser testada (Lafoensia pacari) e o outro recebera Placebo. Resultados esperados: Efetiva acao na erradicacao do Helicobacter pylori superior a 40 por cento um mes apos o termino do experimento) Conclusoes As conclusoes do trabalho serao apresentadas depois da realizacao do mesmo) porem considerando a disponibilidade da Lafoensia pacari em quantidade suficiente para a preparacao das capsulas; considerando que mensalmente sao realizadas 700 endoscopias no Hospital São Paulo/EPM, o que daria, teoricamente, 350 pacientes com positividade para o Helicobacter pylori por mes, uma vez que a infeccao media na populacao mundial corresponde a 50 por cento; considerando que necessitaremos de apenas 160 pacientes e que a duracao do tratamento sera de apenas 10 dias, concluimos que o Projeto e factivel tanto no que concerne a sua realizacao quanto na qualidade do mesmo
- ItemSomente MetadadadosC-13-urea breath test with infrared spectroscopy for diagnosing Helicobacter pylori infection in children and adolescents(Lippincott Williams & Wilkins, 2002-07-01) Kawakami, Elisabetye [UNIFESP]; Machado, Rodrigo Strehl [UNIFESP]; Reber, Marialice [UNIFESP]; Patricio, Francy Reis da Silva [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Background and Objective: Studies support the accuracy of C-13-urea breath test for diagnosing and confirming cure of Helicobacter pylori infection in children. Three methods are used to assess (CO2)-C-13 increment in expired air: mass spectrometry, infrared spectroscopy, and laser-assisted ratio analysis, in this study, the C-13-urea breath test performed with infrared spectroscopy in children and adolescents was evaluated.Methods: Seventy-five patients (6 months to 18 years old) were included. the gold standard for diagnosis was a positive culture or positive histology and a positive rapid urease test. Tests were performed with 50 mg of C-13-urea diluted in 100 mL orange juice in subjects weighing up to 30 kg, or with 75 mg of C-13-urea diluted in 200 mL commercial orange juice for subjects weighing more than 30 kg. Breath samples were collected just before and at 30 minutes after tracer ingestion. the C-13-urea breath test was considered positive When delta over baseline (DOB) was greater than 4.0%.Results: Tests were positive for H. pylori in 31 of 75 patients. Sensitivity was 96.8%, specificity was 93.2%, positive predictive value was 90.9%, negative predictive value was 97.6%, and accuracy was 94.7%. Conclusions: C-13-urea breath test performed with infrared spectroscopy is a reliable, accurate, and noninvasive diagnostic tool for detecting H. pylori infection. (C) 2002 Lippincott Williams Wilkins, Inc.
- ItemSomente MetadadadoscagA vacA alelles and babA2 genotypes of Helicobacter pylori associated with gastric disease in Brazilian adult patients(Elsevier B.V., 2005-04-01) Gatti, L. L.; Souza, EKFE; Leite, K. R.; Bastos, ELD; Vicentini, L. R.; Silva, L. C. da; Smith, MDC; Payao, SLM; Fac Med Marilia; Universidade Federal de São Paulo (UNIFESP); Hosp Sirio Libanes; Universidade de São Paulo (USP)Helicobacter pylori is an important human pathogen that causes chronic gastritis and is associated with development of peptic ulcer disease and gastric malignancies. the vacuolating cytotoxin (vacA), cagA gene, and babA2 gene are important virulence factor involving gastric diseases. Eighty-nine Helicobacter pylori-positive gastric biopsies were analyzed by polymerase chain reaction and Southern blotting for H. pylori detection and genotyping with primer pairs from each virulence gene. Fifty-three strains (59%) were common vacA genotype s1/m1, and only 14 (16%) were s2/m2, 12% of strains was found to have multiple infection. the cagA presence was detected in 48% (43 strains) and babA2 gene was detected in 44% of our H. pylori strains. We observed high percentage of s1/m2 strains with chronic gastritis and peptic ulcer and a significant correlation between cagA presence with the s1 allele and babA2 gene with chronic gastritis. (c) 2005 Elsevier Inc. All rights reserved.
- ItemSomente MetadadadosCarditis is related to Helicobacter pylori infection in dyspeptic children and adolescents(Pacini Editore, 2007-02-01) Carelli, A. P.; Patricio, F. R. S.; Kawakami, E.; Universidade Federal de São Paulo (UNIFESP)Background. Etiology of gastric cardia inflammation is still controversial.Aims. To evaluate the association between carditis and Helicobacter pylori infection and the correlation among inflammatory changes observed in biopsies taken from cardia, corpus, and antrum in a well-defined group of patients.Patients. the mean age of 45 dyspeptic patients was 10.4 years (range 5.1-17.0 years); gender F/M rate: 1.6/1.Methods. A total of 450 specimens from esophagus (2), cardia (2), corpus (3), and antrum (4) were collected for biopsy. the presence of H. pylori was assessed by histology and a rapid urease test. the types of glandular epithelium of cardia found in specimens were identified and both inflammatory changes and H. pylori density were graded.Results. Carditis was present in specimens of 30/45 (66.7%) of the patients. Presence of H. pylori in specimens was detected in the antrum (26/45; 57.8%), in the corpus (19/45; 42.2%), and in the cardia (14/45; 31.1%). There was a strong association between carditis and presence of H. pylori infection (OR = 27.08) by multivariate analysis. the scores for inflammation and activity in the cardia, corpus and antrum have shown a relationship except for both cardia and antrum H. pylori density and corpus and cardia activity. the intensity of gastritis and degree of colonization with H. pylori were significantly higher in the antrum than in both the corpus and the cardia. Pangastritis was highly associated to H. pylori infection in 22/25 (88%) of the patients.Conclusions. 1. Carditis is associated to H. pylori infection in children with symptoms of dyspepsia; 2. the degrees of gastritis found at the cardia were correlated to those at the antrum and body except for both cardia and antrum H. pylori density and corpus and cardia activity. (c) 2006 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier B.V. All rights reserved.
- ItemSomente MetadadadosContribuição ao estudo do campylobacter pylori e sua relação com a doença péptica(Universidade Federal de São Paulo (UNIFESP), 1988) Ferrari, Angelo Paulo [UNIFESP]; Geocze, Stephan [UNIFESP]
- ItemSomente MetadadadosContribuição ao estudo dos linfomas não Hodgkin associados ao HTLV-1, Helicobacter pylori e vírus Epstein-Barr(Universidade Federal de São Paulo (UNIFESP), 2003) Oliveira, José Salvador Rodrigues de [UNIFESP]Os LNH constituem um grupo heterogeneo de doencas. Somente apos a decada de 90 houve mais clareza nas classificacoes, sendo decisiva a individualizacao por oentidades definitivasoe oprovisoriasoconsiderando os aspectos clinicos, morfologicos e moleculares distintos no que foi tido como permanente e criterios ainda nao totalmente admitidos no conceito de oprovisorio. Ainda nao atingimos o ideal, que seria a legitimacao para todos os tipos morfologicos de doencas onco-hematologicas. Os avancos, sem duvida, foram extraordinarios, repercutiram imensamente nas definicoes clinico-patologicas e abriram caminhos para tratamentos mais direcionados. 0 ATL, por ter sido a primeira destas doencas que teve seu agente causal serviu como modelo de oncogenese. Apesar dos imensos progressos nos campos da biologia celular, molecular, genetica, etc, ainda nao sao precisos quais os fatores de cunho genetico que tornam alguns individuos vulneraveis ao ATL, outros ao NAMITSP e ao status de portador assintomatico, que constituem a maioria dos infectados. Dentro do contexto do ATL, as formas distintas de apresentacao como cronica, linfomatosa e indolente, nao tem patogenese completamente elucidada. 0 estabelecimento destas formas clinicas, os estudos soro-epidemioiogicos e o rastreamento familiar possibilitaram a determinacao das vias de contaminacao em nosso meio. Estudos de tipagem do HLA mostram consenso quanto ao papei protetor A2. 0 HLA A26 e DR8 estao associados ao ATL. As pesquisas da genotipagem apontam para a agregacao familiar como fator mantenedor do virus em grupos raciais, como os nativos africanos e japoneses. Ha muito que aprender nesta interessante doenca, sobretudo na sua oncogenese divergente entre as diferentes formas de apresentacao. Apesar destes avancos na biologia do tumor, muito pouco ou quase nada se fez para a cura desta complicada entidade. Os antiretrovirais, a imunoterapia com emprego de anticorpos monoclonais dirigidos contra alvosa(au)