Detecção de lesões precursoras em indivíduos sob risco para o carcinoma epidermoide do esofago : experiência com a histopatologia e a citopatologia da mucosa esofágica através de biopsias endoscopicas e do esfregaco pelo balão citologico chinês

Foram estudados, prosoectivamente, 448 individuas sob risco para o carcinoma epidermóide do esôfago. O estudo foi realizado entre março de 1986 e março de 1991 no Hospital de Clinicas de Porto Alegre / Universidade Federal do Rio Grande do Sul, no Hospital Psiquiátrico São Pedro da Secretaria da Saúde e Meio Ambiente do Estado do Rio Grande do Sul e na Fundação Universitária de Gastroenterologia. Os individuas foram selecionados através de um escore obtido por um questionário para graduação dos fatores de risco (consumo de bebidas alcóolicas, consumo de fumo e consumo de chimarrão) para o carcinoma epidermóide do esOfago. Os individuas foram classificados em dois grupos: grupo "Maior Risco" ( ESCORE 3 ) e grupo "Menor Risco" ( ESCORE 1 ). Foram estudados, inicialmente, no "ESTUDO I", 289 individuas do grupo "Maior Risco" pelo Balão Citológico Chinês para medir a "tolerabilidade" ao exame com o balão e o sucesso" na recuperação de material celular. A tolerabilidade ao balão citológico foi elevada, permitindo o exame em 99,0 % dos individuas. O grau de sucesso na colheita foi também elevado, identificando-se material celular esofágico em 100 % dos examinados. As alterações citopatológicas· foram classificadas em: "Normal", "Atipia de Baixo Grau" , "Atipia de Alto Grau" e "Carcinoma" e as foram 23,2 % respectivamente. No "ESTUDO II", foram avaliados 157 individuas - 60 no grupo "Maior Risco" e 97 no grupo "Menor Risco", através da colheita de material citológico pelo balão chinês e de material histológico pela esofa~oscopia com biópsias por pinças no terço médio do esôfago e as ~uas frequências relativas comparadas entre os dois dois grupos. As alterações histopatológicas encontradas e suas freqüências relativas foram para os grupos "Maior" e "Menor Risco", respectivamente: "Normal" 39,4%, "Esofagite Crônica leve" 31,7 % e 18,2 %, Crônica Moderada" 26,7 % e 21,2 % "Esofagite 18,3 % e "Esofagite Crônica Acentuada"11,7% e 8,1% , "Esofagites - todos os graus" 70,1% e 47,5% ,"Atrofia Epitelial" "Zero" e "Zero" , "Displasias" 3,4 % e 3,0 % , "Carcinoma" "Zero" e "Zero". As "Esofagites Crônicas - todos os graus" foram significativamente mais freqüentes e os "Normais" significativamente menos freqüentes no grupo de "Maior Risco" quando comparados com os de "Menor Risco". As freqüências relativas das alterações citopatológicas encontradas foram as seguintes para os grupos "Maior" e "Menor Risco", respectivamente : "Normal" 21,6 % e 41,4 %, "Atipias de Baixo Grau" 71,7% e 57,6 %, "Atipias de Alto Grau" 1,7% e 1,0 % "Carcinoma" "Zero" e "Zero". Não houve diferença estatistica para os achados citopatológicos entre esses dois grupos no "ESTUDO II". Entretanto, o aumento da amostra dos pacientes com "Maior Risco" ( "ESTUDO I" + "ESTUDO II - a" ) mostrou uma fregüência significativamente mais elevada das "Atipias de Baixo Grau" do grupo "Maior Risco" guando comparadas com o grupo "Menor Risco" ( "ESTUDO II b ".O inverso se observou para os achados "Normais" entre esses dois grupos. No "ESTUDO III", os .. resultados do exame citopatológico pelo balão chinês não mostraram uma correlação significativa com os achados histopatológicos nos grupos "Maior Risco", "Menor Risco" ou nos seus resultados combinados e a Sensibilidade e a Especificidade encontradas não apresentaram significância estatistica

Reduced quality of life in patients with non-erosive gastroesophageal reflux disease

Introduction: Gastroesophageal reflux disease (GERD) is a highly prevalent condition in the Western world. It is a frequent cause of medical appointments and has a high impact on quality of life (QOL). This study aimed to assess health-related quality of life (HQ-QOL) of patients with non-erosive gastroesophageal disease (NERD) and compare their scores with the scores of patients with GERD symptoms and non-pathological acid reflux (non-NERD).Methods: We studied 42 patients with GERD symptoms—21 with positive pHmetry for acid reflux (NERD group) and 21 with negative pHmetry for acid reflux (non-NERD group). We enrolled patients matched by age and gender. Patient inclusion criteria were based on clinical and endoscopic findings and pHmetry. All other major diseases having an impact on QOL were excluded as well as patients in regular use of proton pump inhibitors, prokinetics, histamine-2 receptor antagonists and anti-depressants. All subjects were asked to fill in a validated translation of the SF-36 questionnaire. We described scores trough median and interquartile range (IQR) and assessed the significance of the comparisons through Mann-Whitney test and chi-square test or Student’s t-test when appropriate.Results: We found no significant differences in the eight domains of SF-36 between the two groups.Conclusion: QOL of patients with GERD symptoms was equivalent, regardless of acid reflux at pHmetry.Keywords: SF-36; quality of life; gastroesophageal reflux; pHmetr

Reduced quality of life in patients with non-erosive gastroesophageal reflux disease

Introduction: Gastroesophageal reflux disease (GERD) is a highly prevalent condition in the Western world. It is a frequent cause of medical appointments and has a high impact on quality of life (QOL). This study aimed to assess health-related quality of life (HQ-QOL) of patients with non-erosive gastroesophageal disease (NERD) and compare their scores with the scores of patients with GERD symptoms and non-pathological acid reflux (non-NERD). Methods: We studied 42 patients with GERD symptoms—21 with positive pHmetry for acid reflux (NERD group) and 21 with negative pHmetry for acid reflux (non-NERD group). We enrolled patients matched by age and gender. Patient inclusion criteria were based on clinical and endoscopic findings and pHmetry. All other major diseases having an impact on QOL were excluded as well as patients in regular use of proton pump inhibitors, prokinetics, histamine-2 receptor antagonists and anti-depressants. All subjects were asked to fill in a validated translation of the SF-36 questionnaire. We described scores trough median and interquartile range (IQR) and assessed the significance of the comparisons through Mann-Whitney test and chi-square test or Student’s t-test when appropriate. Results: We found no significant differences in the eight domains of SF-36 between the two groups. Conclusion: QOL of patients with GERD symptoms was equivalent, regardless of acid reflux at pHmetry. Keywords: SF-36; quality of life; gastroesophageal reflux; pHmetr

Reduced quality of life in patients with non-erosive gastroesophageal reflux disease

Introduction: Gastroesophageal reflux disease (GERD) is a highly prevalent condition in the Western world. It is a frequent cause of medical appointments and has a high impact on quality of life (QOL). This study aimed to assess health-related quality of life (HQ-QOL) of patients with non-erosive gastroesophageal disease (NERD) and compare their scores with the scores of patients with GERD symptoms and non-pathological acid reflux (non-NERD). Methods: We studied 42 patients with GERD symptoms—21 with positive pHmetry for acid reflux (NERD group) and 21 with negative pHmetry for acid reflux (non-NERD group). We enrolled patients matched by age and gender. Patient inclusion criteria were based on clinical and endoscopic findings and pHmetry. All other major diseases having an impact on QOL were excluded as well as patients in regular use of proton pump inhibitors, prokinetics, histamine-2 receptor antagonists and anti-depressants. All subjects were asked to fill in a validated translation of the SF-36 questionnaire. We described scores trough median and interquartile range (IQR) and assessed the significance of the comparisons through Mann-Whitney test and chi-square test or Student’s t-test when appropriate. Results: We found no significant differences in the eight domains of SF-36 between the two groups. Conclusion: QOL of patients with GERD symptoms was equivalent, regardless of acid reflux at pHmetry

Acalásia tem alta prevalência e maior demanda no ambulatório de doenças do esôfago e dismotilidade digestivas (AMBESO do Hospital de Clínicas de Porto Alegre (HCPA)

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Hepatitis C virus genotypes in Southern Brazil

The prevalence of hepatitis C virus (HCV) genotypes in Southern Brazil was studied in the plasma of 100 HCV-RNA-positive patients attended in Porto Alegre, South of Brazil. Reverse transcriptionpolymerase chain reaction (RT-PCR) products from the 5' noncoding region were double digested with Rsal-Haeiii and BstNl-Hinfi and analyzed by restriction fragment length polymorphism (RFLP). Three genotypes (1, 2 and 3) were demonstrable, the most prevalent being HCV type I (55 of 100 patients, 55%), followed by HCV type 3 (37 of 100 patients, 37%) and HCVtype 2 (8 oflOO patients, 8%). There was an unusual high prevalence of genotype 3, in contrast to the majority of published data from the Southeast region

Motilidade esofágica ineficaz (MEI) está associada com esofagite de refluxo (ER)?

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