European Registry on the management of Helicobacter pylori infection: Features of diagnosis and treatment in Kazan

© 2020 Consilium Medikum. All rights reserved. Background. As part of an observational multicenter prospective study “European Registry on the management of Helicobacter pylori infection”, conducted on the initiative of the European H. pylori and Microbiota Study Group, the compliance of clinical practice in the management of patients with Helicobacter pylori infection in Kazan with clinical guidelines was assessed. Materials and methods. The data of 437 patients included into the register by clinical sites in Kazan in 2013-2019 were analyzed. The methods used for the initial diagnosis of H. pylori infection and eradication control were evaluated. The frequency of various eradication therapy regimens prescription was analyzed in 379 cases. Data regarding the effectiveness of eradication therapy was analyzed in 173 patients. Results. The rapid urease test (44.2% of cases) and cytology/histology (60% of cases) were most often used for the initial diagnosis of H. pylori infection; however non-invasive methods such as 13C-urea breath (9.2%), serology (6.2%), H. pylori stool antigen test (2.3%) were less common. In 21.7% of patients two methods of H. pylori detection were used for primary diagnosis. The control test to evaluate the effectiveness of eradication therapy at the recommended timepoint was performed in 46.2% of patients. 13C-urea breath test (31.7%), stool PCR/stool antigen test (28.7%), rapid urease test (22.3%), cytology/histology (26.2% of cases) prevailed in the assessment of eradication rate. Standard triple therapy, including proton pump inhibitor, clarithromycin and amoxicillin was most commonly prescribed as first-line therapy (64.6% of cases). The duration of eradication therapy was 14 days in the majority of cases with pantoprazole as the most common proton pump inhibitor in standard triple therapy regimens (84.8%). The efficacy of 14-day standard triple therapy (mITT) was 87.0%. Conclusion. The results indicate a high frequency of non-invasive methods use for assessing the effectiveness of eradication therapy; however, the overall rate of eradication efficacy assessment is low, limiting the possibility of analyzing the eradication results. The effectiveness of the most common 14-day standard triple first-line therapy in Kazan doesn't reach the recommended 90% eradication level. This could be explained by high rate of pantoprazole use, which is not an optimal proton pump inhibitor in eradication therapy regimens

Evaluation of two differents sutures for inciosional laparoscopic Colopexy in dogs : a experimental study

Com o objetivo de descrever técnica laparoscópica para a realização de colopexia em cães, comparando os resultados de dois distintos fios de sutura, os autores utilizaram 10 animais separados em dois grupos de igual número (GV e GP). Nos do GV, a colopexia foi realizada com fio de poliglactina 910 3-0, enquanto no GP empregou-se polipropileno de igual espessura. Para o procedimento, os caninos foram posicionados em decúbito dorsal e submetidos a pneumoperitônio com CO2 na pressão de 12mmHg. Foram introduzidos quatro trocartes, dois de 5mm e dois de 10mm, nas regiões umbilical, lateral direita e esquerda. O cólon descendente foi apreendido com pinça Babcock e submetido a incisão seromuscular de 2,5cm na superfície antimesentérica. Procedeu-se a incisão semelhante no músculo transverso abdominal, paralelamente à linha alba. As margens correspondentes das feridas do intestino e da musculatura abdominal foram aposicionadas com suturas contínuas simples. No 14º dia pós-operatório, os caninos foram submetidos a laparoscopia para as avaliações da cavidade peritoneal e das aderências produzidas, bem como para as coletas de biópsias. Constatou-se permanência da colopexia em todos os animais e a fixação do omento na região da sutura em 60% e 100% dos representantes do GV e do GP, respectivamente. Ambos os fios demonstraram adequabilidade; contudo, a sutura foi realizada mais facilmente com a poliglactina 910, graças à sua menor “memória”. Na histologia, observou-se que a deposição de tecido conjuntivo foi semelhante entre os grupos, sendo que em todos os casos o colágeno apresentava-se maturo. Pode-se concluir que a técnica laparoscópica proposta é adequada para a realização de colopexias em cães.Aiming to describe the laparoscopic technique for dog colopexy and to compare two suture materials 10 mongrel dogs separated in two groups of five (GV e GP). In the GV group the colopexy was realized with a polyglactin 910 3-0, and in the GP group a polypropylene 3-0 was used. For both procedures the dogs were positioned in dorsal recumbence and submitted to a pneumoperitoneum with CO2 using pressure of 12mmHg. Four trocars (two of 5mm and two of 10mm) were introduced in the left and right position of umbilical region. The descendent colon was grasped with a Babcock forceps and submitted to a seromuscular incision of 2.5 cm in the antimesenteric surface. A similar lesion was preceded in the transverse abdominal muscle, parallel with the ventral midline. The incisioned margins of colon and transverse abdominal muscle were sutured in two lines of simple continuous pattern. Fourteen days after the surgeries the dogs were submitted to laparoscopy surgery for evaluations of the peritoneal cavity and of the adherences occurred and to biopsies collections. The colopexy permanence was found in all dogs and the omentum fixation in the suture region was observed in 60% of GV dogs and 100% of GP dogs. Both suture materials were reported adequate for the colopexy procedure, however the polyglactin 910 suture was more easily realized due to its lower memory. In the histological analysis were observed that the connective tissue deposition was similar in both groups and in all 10 dogs the collagen fibers presented mature aspect. Based on the results presented herein, the proposed laparoscopic technique in adequate for colopexy procedure in dogs

Evaluation of two differents sutures for inciosional laparoscopic Colopexy in dogs : a experimental study

Com o objetivo de descrever técnica laparoscópica para a realização de colopexia em cães, comparando os resultados de dois distintos fios de sutura, os autores utilizaram 10 animais separados em dois grupos de igual número (GV e GP). Nos do GV, a colopexia foi realizada com fio de poliglactina 910 3-0, enquanto no GP empregou-se polipropileno de igual espessura. Para o procedimento, os caninos foram posicionados em decúbito dorsal e submetidos a pneumoperitônio com CO2 na pressão de 12mmHg. Foram introduzidos quatro trocartes, dois de 5mm e dois de 10mm, nas regiões umbilical, lateral direita e esquerda. O cólon descendente foi apreendido com pinça Babcock e submetido a incisão seromuscular de 2,5cm na superfície antimesentérica. Procedeu-se a incisão semelhante no músculo transverso abdominal, paralelamente à linha alba. As margens correspondentes das feridas do intestino e da musculatura abdominal foram aposicionadas com suturas contínuas simples. No 14º dia pós-operatório, os caninos foram submetidos a laparoscopia para as avaliações da cavidade peritoneal e das aderências produzidas, bem como para as coletas de biópsias. Constatou-se permanência da colopexia em todos os animais e a fixação do omento na região da sutura em 60% e 100% dos representantes do GV e do GP, respectivamente. Ambos os fios demonstraram adequabilidade; contudo, a sutura foi realizada mais facilmente com a poliglactina 910, graças à sua menor “memória”. Na histologia, observou-se que a deposição de tecido conjuntivo foi semelhante entre os grupos, sendo que em todos os casos o colágeno apresentava-se maturo. Pode-se concluir que a técnica laparoscópica proposta é adequada para a realização de colopexias em cães.Aiming to describe the laparoscopic technique for dog colopexy and to compare two suture materials 10 mongrel dogs separated in two groups of five (GV e GP). In the GV group the colopexy was realized with a polyglactin 910 3-0, and in the GP group a polypropylene 3-0 was used. For both procedures the dogs were positioned in dorsal recumbence and submitted to a pneumoperitoneum with CO2 using pressure of 12mmHg. Four trocars (two of 5mm and two of 10mm) were introduced in the left and right position of umbilical region. The descendent colon was grasped with a Babcock forceps and submitted to a seromuscular incision of 2.5 cm in the antimesenteric surface. A similar lesion was preceded in the transverse abdominal muscle, parallel with the ventral midline. The incisioned margins of colon and transverse abdominal muscle were sutured in two lines of simple continuous pattern. Fourteen days after the surgeries the dogs were submitted to laparoscopy surgery for evaluations of the peritoneal cavity and of the adherences occurred and to biopsies collections. The colopexy permanence was found in all dogs and the omentum fixation in the suture region was observed in 60% of GV dogs and 100% of GP dogs. Both suture materials were reported adequate for the colopexy procedure, however the polyglactin 910 suture was more easily realized due to its lower memory. In the histological analysis were observed that the connective tissue deposition was similar in both groups and in all 10 dogs the collagen fibers presented mature aspect. Based on the results presented herein, the proposed laparoscopic technique in adequate for colopexy procedure in dogs

Laparoscopic techniques in diaphragmatic hernias: experimental study in dogs

A hérnia diafragmática traumática é a forma mais comum entre as hérnias diafragmáticas em cães e gatos e, por tratar-se de uma alteração anatômica, a terapêutica indicada é a sua correção cirúrgica. O presente estudo se propôs a avaliar a cirurgia videolaparoscópica no diagnóstico e tratamento dessa afecção em cães. Na primeira etapa do experimento, os animais foram submetidos à produção de um modelo de hérnia diafragmática. Após o período de uma semana, os cães foram submetidos à segunda etapa experimental por meio do acesso laparoscópico, tendo como finalidade o diagnóstico e a terapêutica cirúrgica. O acesso laparoscópico mostrou-se eficaz tanto na identificação das rupturas e dos deslocamentos como na correção cirúrgica de reposição visceral e rafia diafragmática nos oito cães do experimento.The most common type of diaphragmatic hernia in dogs and cats is the traumatic one. As an anatomic alteration, surgery is the elected treatment. The purpose of this study was to evaluate videolaparoscopic surgery in the diagnostic and treatment of diaphragmatic hernia in dogs. In the first phase of the study diaphragmatic hernias were performed in dogs. One week later the dogs were summited to a laparoscopic surgery to make diagnostic and surgical correction. Laparoscopic access showed to be efficient for identification of the defect and visceral displacement and for the surgical treatment

Efeitos da solução salina hipertônica a 7,5% em glicose a 5% nas concentrações séricas de sódio, cloreto e potássio de eqüinos com hipovolemia induzida Effects of 7,5% hypertonic saline in 5% glucose on serum levels of sodium, chloride and potassium in induced hypovolemic horses

Estudaram-se os efeitos de soluções salinas isotônica e hipertônica em eqüinos hipovolêmicos sobre as concentrações séricas de sódio, cloreto e potássio e freqüências cardíaca (FC) e respiratória (FR). Quinze eqüinos machos com peso entre 390 e 475kg e idades entre quatro e 18 anos foram submetidos à retirada de sangue correspondente a 2% do peso corporal e distribuídos em três grupos de igual número: o grupo GSH recebeu solução hipertônica de NaCl a 7,5% em glicose a 5%; o GSI, solução isotônica de NaCl a 0,9%; e o GC não foi tratado. Os eletrólitos séricos foram avaliados antes (T0), após a retirada de sangue (T1) e após a infusão das soluções, entre 20 e 30 minutos (T2), entre 60 e 70 minutos (T3) e entre 120 e 130 minutos (T4). Após T0, houve elevação da FC e da FR, e as concentrações séricas de Na, Cl, K permaneceram inalteradas. Após a infusão, houve melhora das variáveis clínicas em GSI e GSH, em relação ao GC. Quanto a T3 e T4, os valores de Na em T2 do GSH foram maiores, e os de Cl e de K não se alteraram. As soluções hipertônica e isotônica são seguras na correção da hipovolemia induzida e não produzem alteração eletrolítica significativa.<br>The effect of isotonic and hypertonic solutions on serum levels of sodium, chloride and potassium and cardiac (CR) and respiratory rates (RR) of hypovolemic horses were studied. Fifteen horses weighting from 390 to 475kg, aging from four to 18-years-old were submitted to bleeding of 2% of body weight and divided in three groups: 7.5% NaCl hypertonic saline in 5% glucose (GSH), 0.9% NaCl isotonic saline and control group (GC). Serum electrolytes were evaluated before (T0) and after bleeding (T1) and after the administration of the solutions between 20 and 30 minutes (T2), 60 and 70 minutes (T3) and 120 and 130 minutes (T4). After T0, CR and RR increased while serum sodium, chloride, potassium were not affected. After the treatment, the clinical variables improved in GSI and GSH as compared to GC. The Na levels increased in GSH at T2 being higher than T3 and T4 while chloride and potassium concentrations did not change. The hypertonic and isotonic solutions safely corrected the hypovolemia of the horses, without altering significantly the electrolyte balance

Higher airborne pollen concentrations correlated with increased SARS-CoV-2 infection rates, as evidenced from 31 countries across the globe

Pollen exposure weakens the immunity against certain seasonal respiratory viruses by diminishing the antiviral interferon response. Here we investigate whether the same applies to the pandemic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is sensitive to antiviral interferons, if infection waves coincide with high airborne pollen concentrations. Our original hypothesis was that more airborne pollen would lead to increases in infection rates. To examine this, we performed a cross-sectional and longitudinal data analysis on SARS-CoV-2 infection, airborne pollen, and meteorological factors. Our dataset is the most comprehensive, largest possible worldwide from 130 stations, across 31 countries and five continents. To explicitly investigate the effects of social contact, we additionally considered population density of each study area, as well as lockdown effects, in all possible combinations: without any lockdown, with mixed lockdown−no lockdown regime, and under complete lockdown. We found that airborne pollen, sometimes in synergy with humidity and temperature, explained, on average, 44% of the infection rate variability. Infection rates increased after higher pollen concentrations most frequently during the four previous days. Without lockdown, an increase of pollen abundance by 100 pollen/m3 resulted in a 4% average increase of infection rates. Lockdown halved infection rates under similar pollen concentrations. As there can be no preventive measures against airborne pollen exposure, we suggest wide dissemination of pollen−virus coexposure dire effect information to encourage high-risk individuals to wear particle filter masks during high springtime pollen concentrations