Short-term triple therapy with azithromycin for Helicobacter pylori eradication: Low cost, high compliance, but low efficacy

<p>Abstract</p> <p>Background</p> <p>The Brazilian consensus recommends a short-term treatment course with clarithromycin, amoxicillin and proton-pump inhibitor for the eradication of <it>Helicobacter pylori </it>(<it>H. pylori)</it>. This treatment course has good efficacy, but cannot be afforded by a large part of the population. Azithromycin, amoxicillin and omeprazole are subsidized, for several aims, by the Brazilian federal government. Therefore, a short-term treatment course that uses these drugs is a low-cost one, but its efficacy regarding the bacterium eradication is yet to be demonstrated. The study's purpose was to verify the efficacy of <it>H. pylori </it>eradication in infected patients who presented peptic ulcer disease, using the association of azithromycin, amoxicillin and omeprazole.</p> <p>Methods</p> <p>Sixty patients with peptic ulcer diagnosed by upper digestive endoscopy and <it>H. pylori </it>infection documented by rapid urease test, histological analysis and urea breath test were treated for six days with a combination of azithromycin 500 mg and omeprazole 20 mg, in a single daily dose, associated with amoxicillin 500 mg 3 times a day. The eradication control was carried out 12 weeks after the treatment by means of the same diagnostic tests. The eradication rates were calculated with 95% confidence interval.</p> <p>Results</p> <p>The eradication rate was 38% per intention to treat and 41% per protocol. Few adverse effects were observed and treatment compliance was high.</p> <p>Conclusion</p> <p>Despite its low cost and high compliance, the low eradication rate does not allow the recommendation of the triple therapy with azithromycin as an adequate treatment for <it>H. pylori </it>infection.</p

POTENTIAL CROSS-CONTAMINATION OF SIMILAR Giardia duodenalis ASSEMBLAGE IN CHILDREN AND PET DOGS IN SOUTHERN BRAZIL, AS DETERMINED BY PCR-RFLP

Giardia duodenalis is an enteric parasite that has distinct genetic groups. Human infections are mainly caused by assemblages A and B, although sporadic infections by assemblages C and D have also been reported. Animals can be infected by a wide range of assemblages (A to H). The aim of this study is to identify the assemblages and sub-assemblages of G. duodenalis with zoonotic features in fecal samples of school-aged children, and in dogs that coexist in the same households in Lages, Santa Catarina, Brazil. Fecal samples of 91 children and 108 dogs were obtained and G. duodenalis cysts were detected in samples from 11 (12.08%) children and 10 (9.25%) dogs. DNA extracted from the 21 positive samples was analyzed by PCR-RFLP, using the gdh gene. Results showed the presence of sub-assemblages AI (2/11), AII (4/11), BIII (2/11), and BIV(3/11) among children and AI (5/10) and BIV(3/10) in dogs, with zoonotic characteristics, and the carnivore specific assemblage C (2/10). G. duodenalis was found to infect both children and dogs living in the same household, with the same sub-assemblage (BIV) indicating that pet dogs are a potential risk of transmission of G. duodenalis to humans

Prevalência e características das feridas em pessoas idosas residentes na comunidade

RESUMO Objetivo Descrever o perfil e as características de idosos com restrição de mobilidade, residentes na comunidade e com presença de lesões de pele. Método Estudo exploratório e descritivo, parte do Estudo SABE – Saúde Bem-estar e Envelhecimento que avaliou a presença de lesões de pele em uma amostra probabilística de idosos residentes no município de São Paulo segundo aspectos sociodemográficos, biomarcadores sanguíneos, condições de saúde e utilização de serviços. A análise utilizou o teste de qui-quadrado com correção de Rao-Scott para amostras complexas com nível de significância de 5%. Resultados No ano de 2010, 20,7% dos idosos com restrição de mobilidade apresentavam lesões na pele em decorrência desse problema. Os locais mais frequentes foram região sacral para ambos os sexos, escapular para mulheres e trocanteriana para homens. Idade mais avançada, multimorbidade e comprometimento funcional foram mais prevalentes entre os idosos com feridas, assim como a maior frequência de cuidado requerido. A disfuncionalidade familiar mostrou-se associada à maior sobrecarga do cuidador que pode refletir na qualidade do cuidado prestado. Observou-se que esses idosos que são prioritários para a atenção domiciliar não a recebem adequadamente. Conclusão A prevalência de lesões de pele em idosos com restrição de mobilidade na comunidade é baixa, no entanto requerem atenção diferenciada e essa não está sendo adequadamente oferecida. A reorganização das políticas e serviços assistenciais mostra-se essencial

Hematopoietic stem cell transplantation in a severe refractory Crohn&rsquo;s disease patient with intestinal stoma: a case report

Milton Artur Ruiz,1 Roberto Luiz Kaiser Junior,2 Luiz Gustavo de Quadros,2 Gustavo Henrique Xavier Caseiro,2 Aderson Francisco Oliveira,1 Tatiana Pe&ntilde;a-Arciniegas,1 Lilian Piron-Ruiz,1 Fernanda Soubhia Liedtke Kaiser,2 Vera Lucia Oliveira2 1Bone Marrow Transplant Department, Associa&ccedil;&atilde;o Portuguesa de Beneficencia de S&atilde;o Jos&eacute; do Rio Preto, 2Kaiser Clinica, Centro M&eacute;dico Avan&ccedil;ado de S&atilde;o Jos&eacute; do Rio Preto, Sao Paulo, Brazil Background: Hematopoietic stem cell transplantation (HSCT) can be used in the treatment of patients with refractory Crohn&rsquo;s disease (CD) when no alternative treatment is available. However, HSCT increases the risk of infections, in particular during the aplasia of mobilization and conditioning. Moreover, intestinal stomas in CD augment the risk of morbidity in immunocompromised patients and under aplastic conditions. The objective of this report was to describe the results of the first year after HSCT in a CD patient with an intestinal stoma. Methods: The patient was assessed in respect to disease symptoms and endoscopic findings before the procedure and 30, 90, 180, and 365 days after HSCT.Results: No complications were observed during mobilization and conditioning with sufficient CD34+ cells being harvested in just one apheresis session. Toxicity was restricted to the hematological series. Scores of all the CD indexes and the quality of life of the patient improved. However, two of three endoscopic scores remained unchanged even though improvements were found in the appearance of the lesions.Conclusion: HSCT may be an alternative treatment for refractory CD in patients with an intestinal stoma, and a priori, carefully selected patients with stomas should not be excluded as candidates for this procedure. Keywords: Crohn&rsquo;s disease, intestinal stoma, hematopoietic stem cell transplant, stem cell therapy, autologous HSCT, autoimmune diseases, nonmyeloablative HSC