\u3cem\u3eHelicobacter pylori\u3c/em\u3e infection in Havana, Cuba. Prevalence and \u3cem\u3ecagA\u3c/em\u3e status of the strains

There is a great paucity of information about Helicobacter pylori infection in the countries of the Caribbean basin. Almost no studies have been performed to determine the prevalence, antibiotic resistance or virulence factors of the bacterium. To measure the prevalence of H. pylori infection among patients attending endoscopy in three clinics in Havana, Cuba, to evaluate clarithromycin resistance, and to determine the cagA status of the strains obtained. Endoscopy was performed and biopsies were obtained from 117 successive patients attending the Institute of Oncology, the Institute of Gastroenterology, and the Calixto Garcia Hospital in Havana, Cuba. Biopsies were maintained at –70 ºC before being cultured on three different media (two selective and one non-selective) and incubated for 7 days at 37 °C under a microaerobic atmosphere. The presence of H. pylori was identified by oxidase, catalase and urease activities. DNA was extracted, and PCR was performed with primers H2761676 which amplify a 397 bp fragment of the cagA gene. Clarithromycin susceptibility was measured by the gel diffusion method. The diagnoses of patients were: 1 gastric carcinoma; 19 duodenal ulcers; 8 gastric ulcers; and 89 non-ulcer dyspepsia, including (62) gastritis, (9) hiatal hernia,(2) biliary reflux, (1) gastric polyps, and (15) no abnormality. Among the 117 biopsies tested, 83 were H. pylori positive (70.9%). The cagA status determined for 35 cases gave a positive result in 31 cases (88.5%). Only 3% of the strains were resistant to clarithromycin. The prevalence of Helicobacter pylori infection in the symptomatic population of La Habana is the same as reported for other developing countries. Most strains were cagA positive and are likely harbour the cag pathogenicity island. The low resistance to clarithromycin in the strains studied probably reflects the low degree of use of the antibiotic in this population

Campylobacter Antimicrobial Drug Resistance among Humans, Broiler Chickens, and Pigs, France

We describe isolates from human Campylobacter infection in the French population and the isolates' antimicrobial drug resistance patterns since 1986 and compare the trends with those of isolates from broiler chickens and pigs from 1999 to 2004. Among 5,685 human Campylobacter isolates, 76.2% were C. jejuni, 17.2% C. coli, and 5.0% C. fetus. Resistance to nalidixic acid increased from 8.2% in 1990 to 26.3% in 2004 (p<10-3), and resistance to ampicillin was high over time. Nalidixic acid resistance was greater for C. coli (21.3%) than for C. jejuni (14.9%, p<10-3). C. jejuni resistance to ciprofloxacin in broilers decreased from 31.7% in 2002 to 9.0% in 2004 (p = 0.02). The patterns of resistance to quinolones and fluoroquinolones were similar between 1999 and 2004 in human and broiler isolates for C. jejuni. These results suggest a potential benefit of a regulation policy limiting use of antimicrobial drugs in food animals

Infección por Helicobacter pylori en Santo Domingo, República Dominicana Infection caused by Helicobacter pylori in Santo Domingo, Dominican Republic

Se determinó la Helicobacter pylori (Hp)-seroprevalencia en un grupo de 100 pacientes, sometidos a una endoscopia del tracto digestivo en un centro hospitalario de la ciudad de Santo Domingo. La información relacionada con la edad, el sexo, la raza y los síntomas clínicos fue recogida. Se empleó la técnica de Pyloriset EIA-IIIG from Orion Diagnostic (Finland), a los sueros obtenidos para determinar la Hp-seroprevalencia (IgG). La causa de las endoscopias en 80 % fue epigastralgia. El promedio de edad fue de 43 años, con 54 hombres y 46 mujeres. Diagnóstico endoscópico: úlcera duodenal (6); úlcera gástrica (14); dispepsia no ulcerosa (80): gastritis (62), hernia hiatal (3), reflujo biliar (1), esofagitis (2), panendoscopias normales (12). Del total de 100 sueros testados, 84 fueron positivos (84 %). La prevalencia de la infección por H. pylori en Santo Domingo es alta y se corresponde con la prevalencia reportada en países en vías de desarrollo. Fuertes estudios son necesarios para completar la epidemiología de la infección a H. pylori en la región del Caribe.The seroprevalence of Helicobacter pylori (Hp) was determined in a group of 100 patients undergoing a digestive tract endoscopy in a hospital of Santo Domingo city. The information related to age, sex, race and clinical symptoms was gathered. The Pyloriset EIA-IIIG from Orion Diagnostic (Finland) was used in the sera obtained to determine the Hp-seroprevalence (IgG). Epigastralgia was the cause of endoscopies in 80 % of the patients. Average age was 43 years old, with 54 males and 46 females. Endoscopic diagnosis: duodenal ulcer (6); gastric ulcer (14); non-ulcerous dispepsia (80); gastritis (62); hyatal hernia (3), biliary reflux (1); esophagitis (2), and normal panendoscopies (12). Of the total of 100 tested sera, 84 were positive (84 %). The prevalence of infection due to H. Pylori in Dominican Republic is high and it corresponds with the prevalence reported in the developing countries. Further studies are necessary to complete the epidemiology of H. pylori infection in the Caribbean region

Gaucher disease: french registry cohort of 94 patients treated with eliglustat

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A Review of Gaucher Disease Pathophysiology, Clinical Presentation and Treatments

Gaucher disease (GD, ORPHA355) is a rare, autosomal recessive genetic disorder. It is caused by a deficiency of the lysosomal enzyme, glucocerebrosidase, which leads to an accumulation of its substrate, glucosylceramide, in macrophages. In the general population, its incidence is approximately 1/40,000 to 1/60,000 births, rising to 1/800 in Ashkenazi Jews. The main cause of the cytopenia, splenomegaly, hepatomegaly, and bone lesions associated with the disease is considered to be the infiltration of the bone marrow, spleen, and liver by Gaucher cells. Type-1 Gaucher disease, which affects the majority of patients (90% in Europe and USA, but less in other regions), is characterized by effects on the viscera, whereas types 2 and 3 are also associated with neurological impairment, either severe in type 2 or variable in type 3. A diagnosis of GD can be confirmed by demonstrating the deficiency of acid glucocerebrosidase activity in leukocytes. Mutations in the GBA1 gene should be identified as they may be of prognostic value in some cases. Patients with type-1 GD—but also carriers of GBA1 mutation—have been found to be predisposed to developing Parkinson’s disease, and the risk of neoplasia associated with the disease is still subject to discussion. Disease-specific treatment consists of intravenous enzyme replacement therapy (ERT) using one of the currently available molecules (imiglucerase, velaglucerase, or taliglucerase). Orally administered inhibitors of glucosylceramide biosynthesis can also be used (miglustat or eliglustat)

Infección por Helicobacter pylori en la Ciudad de La Habana, Cuba.Prevalencia de las cepas cagA positivas

Existe una gran falta de información acerca de la infección por Helicobacter pylori en los países de la región del Caribe. Nuestros objetivos en este estudio fueron determinar la prevalencia, la resistencia a los antibióticos y los factores de virulencia de la bacteria. La medida de la prevalencia de la infección por H. pylori se determinó en un grupo de pacientes a los que se les practicó una endoscopia en tres centros hospitalarios de La Ciudad de La Habana, lo que nos permitió evaluar la resistencia a la claritromicina y la presencia de cagA + en las cepas obtenidas. De las endoscopias realizadas se obtuvieron 117 biopsias gástricas, procedentes de tres centros hospitalarios de La Ciudad de La Habana, Cuba: Instituto de Oncología, Instituto de Gastroenterología y el Hospital Calixto García. Las biopsias fueron mantenidas a –70 ºC para posterior cultivo en tres medios diferentes (dos selectivos y uno no selectivo) y su posterior incubación por 7 días a 37 ºC en una atmósfera de microaerofilia. La presencia de H. pylori fue identificada por la presencia de diferentes enzimas (oxidasa, catalasa, ureasa). Se realizó la extracción del DNA y la PCR, donde se utilizó el primer H2761676 y se amplificó con 397 fragmentos del gen cagA. La susceptibilidad a la claritromicina fue medida por el método de difusión en gel. Diagnóstico endoscópico: (1) cáncer gástrico; (19) úlcera duodenal; (8) úlcera gástrica; (89) dispepsias no ulcerosas, incluyendo (62) gastritis; (9) hernia hiatal; (2) reflujo biliar; (1) pólipo gástrico; (15) panendoscopias normales. Del total de 117 biopsias realizadas, 83 fueron positivas a la infección por H.pylori (70,9% ). De las 35 cepas a las que se les realizó presencia de cagA+ resultaron positivas 31 (88,5%). Solo el 3% de las cepas fueron resistentes a la claritromicina. La prevalencia de la infección por H. pylori en la población sintomática de La Ciudad de La Habana es la misma que la reportada en países desarrollados. La mayoría de las cepas fueron cagA positivas y son probablemente el puerto de la Isla de patogenicidad (cagPAI). La baja resistencia a la claritromicina en las cepas estudiadas, probablemente refleja la escasa utilización de este antibiótico en la población estudiada

Prevalence of autoantibodies in the course of Gaucher disease type 1: A multicenter study comparing Gaucher disease patients to healthy subjects

International audienceType 1 Gaucher disease may be related to the presence of autoantibodies. Their clinical significance is questioned. Primary endpoint was to compare the prevalence of autoantibodies in type 1 Gaucher disease patients with healthy subjects, seeking correlations with autoimmune characteristics. Secondary endpoints were to determine whether patients with autoantibodies reported autoimmunity-related symptoms and if genotype, splenectomy or treatment influenced autoantibodies presence

French experience in the evaluation of plasma CCL18 levels in Gaucher Disease type 1

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