Diagnóstico y seguimiento de cáncer de piel no-melanoma utilizando 99mTc-MIBI : estudios en un modelo animal

El objetivo consistió en evaluar la utilidad del 99mTc-MIBI como marcador para diagnóstico y seguimiento de la progresión tumoral del NMSC en un modelo de carcinogénesis completa en ratones. Los animales en estudio fueron inyectados con 99mTc-MIBI a diferentes tiempos y eutanasiados. Se disecaron muestras de tumor y piel sana para evaluar la captación del radiofármaco y realizar el diagnóstico histológico. En animales con 22 semanas de progresión tumoral se observó una diferencia significativa en la captación del 99mTc-MIBI entre piel sana y NMSC. El protocolo que mejor se adapta al uso del 99mTc-MIBI como marcador para el diagnóstico y seguimiento de la progresión tumoral en ratones portadores de NMSC inducidos es la administración i.v de 1 mCi de 99mTc-MIBI con adquisición de datos a los 30 minutos post inyección. Se observó que a medida que los tumores progresan, la captación de 99mTc-MIBI disminuye respecto a la piel normal.The aim of the work was to evaluate the usefulness of 99mTc-MIBI as a tracer for the tumor diagnosis and progression of NMSC in a chemically induced model in mice. After administration of 99mTc-MIBI animals were sacrificed at different times. Samples of tumor and healthy skin were dissected in order to perform histological analysis and to evaluate 99mTc-MIBI uptake. Animals under 22 weeks of tumor evolution showed a statistically difference in 99mTc-MIBI uptake between healthy skin and NMSC. Our results showed that the better protocol for the study of the tumor diagnosis and progression of NMSC in mice is the administration of 1 mCi of 99mTc-MIBI and acquisition of images 30 minutes post injection. Results showed that, as tumor progresses, the uptake of 99mTc-MIBI is significantly lower than healthy skin.Fil: Salgueiro, María Jimena. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; ArgentinaFil: Tesan, Fiorella Carla. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Palmieri, Mónica Alejandra. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Biodiversidad y Biología Experimental; ArgentinaFil: Durán, Hebe. Universidad Nacional de San Martín. Escuela de Ciencia y Tecnología; Argentina. Comisión Nacional de Energía Atómica; ArgentinaFil: Medina, Vanina Araceli. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Leonardi, Natalia. Laboratorios BACON; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; ArgentinaFil: Goldman, Cinthia Gabriela. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; ArgentinaFil: Boccio, Jose Ruben. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; ArgentinaFil: Zubillaga, Marcela Beatriz. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; Argentin

Prevalence of Helicobacter pylori infection and associated factors among adults in Southern Brazil: a population-based cross-sectional study

BACKGROUND: Helicobacter pylori (Hp) infection is associated with several upper gastrointestinal disorders. Local data on the epidemiology of the infection are scarce in Brazil. The purpose of this study is to measure the prevalence rate and to explore the associated factors among the adult population living in Pelotas, a southern Brazilin city. METHODS: This was a population-based cross-sectional study. Through a multi-stage sampling method all individuals 20 years and over living at the selected households at the urban area of the city were interviewed regarding past and current socio-economic indicators; demographic characteristics; nutritional and behavioural habits; and history of upper gastrointestinal symptoms.Hp infection was ascertained through the (13)C-UBT. Due to the high prevalence, data were analysed through robust Poisson regression. All analyses took into account the family clustering of the data. RESULTS: Among 563 eligible individuals, 363 agreed to perform the (13)C-UBT (refusal rate of 35.5%). Refusals were associated with female sex, consumption of mate drinking, and presence of upper gastrointestinal symptoms. The prevalence rate of H. pylori infection was 63.4% (95%CI 59.3%–69.3%). In crude analyses, prevalence was associated with increasing age, non-white skin colour, lower current family income, lower education level, higher size of the family, low socio-economic conditions in childhood, higher number of siblings and attendance to day-care centres in childhood, and presence of dyspeptic symptoms. In adjusted analysis the level of education of the father was inversely associated with the infection, whereas number of siblings and attendance to day-care centre in childhood were directly associated with it. Non-white skin colour remained significantly associated with increased prevalence even after allowing for past and current socio-economic characteristics, age and sex. Compared to non-symptomatic individuals, those reporting dyspeptic symptoms presented a higher prevalence of the infection even after allowing for current and past socio-economic conditions, ethnicity, age, and sex. CONCLUSION: Hp infection is as common among adults in southern Brazil as it is in other developing countries. Socio-economic conditions in childhood besides ethnicity and presence of dyspeptic symptoms were the factors significantly associated with the infection

Validity of an epidemiologic instrument for H. pylori screening among dyspeptic patients

Submitted by Thainã Moraes ([email protected]) on 2012-09-21T18:41:46Z No. of bitstreams: 1 Validade de instrumento.pdf: 135252 bytes, checksum: 02af379a10d140c7bde6b4dd21493c44 (MD5)Approved for entry into archive by Gabriela Silva da Rosa([email protected]) on 2012-09-26T19:21:46Z (GMT) No. of bitstreams: 1 Validade de instrumento.pdf: 135252 bytes, checksum: 02af379a10d140c7bde6b4dd21493c44 (MD5)Made available in DSpace on 2012-09-26T19:21:46Z (GMT). No. of bitstreams: 1 Validade de instrumento.pdf: 135252 bytes, checksum: 02af379a10d140c7bde6b4dd21493c44 (MD5) Previous issue date: 2009OBJETIVO: Validar um escore epidemiológico para identifi car dispépticos positivos para Helicobacter pylori. MÉTODOS: Estudo transversal realizado com 434 indivíduos entre 18 e 45 anos de idade, portadores de dispepsia não investigada, usuários de unidades básicas de saúde de Pelotas (RS), entre 2006 e 2007. Dispepsia foi diagnosticada conforme Roma-II. O padrão-ouro para presença de H. pylori foi o teste respiratório com 13C-uréia. Analisou-se a associação entre H. pylori e variáveis independentes por regressão logística. O escore foi construído a partir de odds ratios ajustadas. Foram calculadas a sensibilidade, especifi cidade e valores preditivos. RESULTADOS: Dentre os dispépticos, a prevalência de H. pylori foi 74% (IC 95%: 69;77,7) e esteve associada diretamente à idade e número de irmãos na infância e inversamente à escolaridade, sendo essas variáveis utilizadas na construção do escore. Os valores do escore variaram de 3-9. Escores entre 7, 8 e 9 apresentaram sensibilidade, respectivamente, de 36,6%, 22,3% e 11,1%; evalores preditivos positivos 87,8%, 90,9% e 92,1%. Sem a aplicação do escore, três de cada quatro dispépticos receberiam tratamento para H. pylori, com a aplicação, menor número de dispépticos seriam encaminhados para tratamento (um em cada três, seis e 11, respectivamente, com os pontos de corte entre 7 me 9), porém às custas de alta taxa de casos falso-negativos. CONCLUSÕES: O escore não foi válido para identifi cação seletiva de dispépticos candidatos a tratamento erradicador para H. pylori. Diferentemente do recomendado para países desenvolvidos, a alta prevalência de H. pylori torna a estratégia testar-e-tratar inapropriada para uso nos países em desenvolvimento.OBJECTIVE: To validate an epidemiological score for identifying dyspeptic patients at high risk of being H. pylori positive. METHODS: Cross-sectional study including 434 users of primary health care units in the city of Pelotas, Southern Brazil, aged 18-45 years, and with symptoms of non investigated dyspepsia, between 2006 and 2007. Dyspepsia was diagnosed according to Roma-II. The gold standard for H. pylori infection was the 13C-urea-breath-test. The association between presence of H. pylori and independent variables was assessed through Logistic Regression. The score was built based on adjusted odds ratios. Sensitivity, specifi city, and predictive values of different cutoffs were calculated. RESULTS: Prevalence of H. pylori dyspeptic subjects was 74% (95% CI: 69;77.7). Prevalence was directly associated with age and number of siblings during childhood, and inversely associated with schooling; these variables were used in the construction of the score. The score ranged from 3 to 9 points. Scores 7, 8, and 9 had sensitivity of 36.6%, 22.3%, and 11.1%, and positive predictive values of 87.8%, 90.9%, and 92.1%, respectively. Without the score, 3 in every 4 dyspeptic patients would have received H. pylori eradication therapy. This proportion would have been lower with the score (one in three, six, and 11, for the cutoff points betwewen 7 and 9, respectively), albeit at the expense of a high rate of false-negatives. CONCLUSIONS: The score was not valid for selectively identifying dyspeptic individuals candidate to eradication therapy for H. pylori. Contrary to the recommendation in developed countries, the test-and-treat strategy seems inappropriate for use in developing settings due to the high prevalence of H. pylori infection

Validade de instrumento epidemiológico para rastrear H. pylori entre pacientes dispépticos

OBJETIVO: Validar um escore epidemiológico para identifi car dispépticos positivos para Helicobacter pylori. MÉTODOS: Estudo transversal realizado com 434 indivíduos entre 18 e 45 anos de idade, portadores de dispepsia não investigada, usuários de unidades básicas de saúde de Pelotas (RS), entre 2006 e 2007. Dispepsia foi diagnosticada conforme Roma-II. O padrão-ouro para presença de H. pylori foi o teste respiratório com 13C-uréia. Analisou-se a associação entre H. pylori e variáveis independentes por regressão logística. O escore foi construído a partir de odds ratios ajustadas. Foram calculadas a sensibilidade, especifi cidade e valores preditivos. RESULTADOS: Dentre os dispépticos, a prevalência de H. pylori foi 74% (IC 95%: 69;77,7) e esteve associada diretamente à idade e número de irmãos na infância e inversamente à escolaridade, sendo essas variáveis utilizadas na construção do escore. Os valores do escore variaram de 3-9. Escores entre 7, 8 e 9 apresentaram sensibilidade, respectivamente, de 36,6%, 22,3% e 11,1%; evalores preditivos positivos 87,8%, 90,9% e 92,1%. Sem a aplicação do escore, três de cada quatro dispépticos receberiam tratamento para H. pylori, com a aplicação, menor número de dispépticos seriam encaminhados para tratamento (um em cada três, seis e 11, respectivamente, com os pontos de corte entre 7 me 9), porém às custas de alta taxa de casos falso-negativos. CONCLUSÕES: O escore não foi válido para identifi cação seletiva de dispépticos candidatos a tratamento erradicador para H. pylori. Diferentemente do recomendado para países desenvolvidos, a alta prevalência de H. pylori torna a estratégia testar-e-tratar inapropriada para uso nos países em desenvolvimento.OBJECTIVE: To validate an epidemiological score for identifying dyspeptic patients at high risk of being H. pylori positive. METHODS: Cross-sectional study including 434 users of primary health care units in the city of Pelotas, Southern Brazil, aged 18-45 years, and with symptoms of non investigated dyspepsia, between 2006 and 2007. Dyspepsia was diagnosed according to Roma-II. The gold standard for H. pylori infection was the 13C-urea-breath-test. The association between presence of H. pylori and independent variables was assessed through Logistic Regression. The score was built based on adjusted odds ratios. Sensitivity, specifi city, and predictive values of different cutoffs were calculated. RESULTS: Prevalence of H. pylori dyspeptic subjects was 74% (95% CI: 69;77.7). Prevalence was directly associated with age and number of siblings during childhood, and inversely associated with schooling; these variables were used in the construction of the score. The score ranged from 3 to 9 points. Scores 7, 8, and 9 had sensitivity of 36.6%, 22.3%, and 11.1%, and positive predictive values of 87.8%, 90.9%, and 92.1%, respectively. Without the score, 3 in every 4 dyspeptic patients would have received H. pylori eradication therapy. This proportion would have been lower with the score (one in three, six, and 11, for the cutoff points betwewen 7 and 9, respectively), albeit at the expense of a high rate of false-negatives. CONCLUSIONS: The score was not valid for selectively identifying dyspeptic individuals candidate to eradication therapy for H. pylori. Contrary to the recommendation in developed countries, the test-and-treat strategy seems inappropriate for use in developing settings due to the high prevalence of H. pylori infection

Iron, zinc, and copper nutritional status in children infected with helicobacter pylori

OBJECTIVE: Helicobacter pylori colonizes the gastric mucosa of about half of the world's population and it has been related to extragastrointestinal diseases. The present study sought to evaluate the association between H pylori infection and iron, zinc, and copper nutritional status in symptomatic children. Patients and Methods: A cross-sectional study was carried out in 395 children (4-16 years) with upper gastrointestinal symptoms, who were tested for H pylori infection by the 13 C-urea breath test. Iron status was determined by hemoglobin, serum ferritin, and serum transferrin receptors. Copper and zinc serum concentrations were also evaluated. Epidemiological data, dietary assessment, and anthropometric indicators were analyzed as potential confounding factors. Results: Prevalence of H pylori infection was 24.3%. Anemia and iron deficiency (ID) were found in 12.0% and 14.3% of the H pylori-positive and 8.9% and 11.0% of the H pylori-negative children, respectively. There was no association between H pylori infection and anemia (odds ratio = 1.54 [95% confidence interval [CI] 0.73%-3.24%]) or ID (odds ratio = 1.35 [95% CI 0.67-2.70]). Crude β coefficients showed that H pylori has no significant effect on hemoglobin, serum ferritin, serum transferrin receptors, copper, and zinc concentrations. However, adjusted results suggested that H pylori-infected children had an increase of 9.74 μg/dL (95% CI 2.12-17.37 μg/dL) in copper concentrations. Conclusions: This study revealed that H pylori infection was not associated with iron deficiency, anemia, or zinc concentrations; however, a positive relation with copper status was found after adjusting for confounding factors. The contribution of H pylori infection to higher copper concentrations needs to be confirmed by additional studies.Fil: Janjetic, Mariana Andrea. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Provincia de Buenos Aires. Ministerio de Salud. Hospital de Niños "Sor María Ludovica" de La Plata; ArgentinaFil: Goldman, Cinthia Gabriela. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Provincia de Buenos Aires. Ministerio de Salud. Hospital de Niños "Sor María Ludovica" de La Plata; ArgentinaFil: Balcarce, Norma E.. Provincia de Buenos Aires. Ministerio de Salud. Hospital de Niños "Sor María Ludovica" de La Plata; ArgentinaFil: Rua, Eduardo Cueto. Provincia de Buenos Aires. Ministerio de Salud. Hospital de Niños "Sor María Ludovica" de La Plata; ArgentinaFil: Beltrán González, Andrea Natalia. Provincia de Buenos Aires. Ministerio de Salud. Hospital de Niños "Sor María Ludovica" de La Plata; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Investigaciones en Ingeniería Genética y Biología Molecular "Dr. Héctor N. Torres"; ArgentinaFil: Fuda, Julián Andrés. Universidad de Buenos Aires. Facultad de Medicina; ArgentinaFil: Meseri, Emiliano I.. Universidad de Buenos Aires. Facultad de Medicina; ArgentinaFil: Torti, Horacio Emilio. Universidad de Buenos Aires. Facultad de Medicina; ArgentinaFil: Barrado, Julieta. Provincia de Buenos Aires. Ministerio de Salud. Hospital de Niños "Sor María Ludovica" de La Plata; ArgentinaFil: Zubillaga, Marcela Beatriz. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Provincia de Buenos Aires. Ministerio de Salud. Hospital de Niños "Sor María Ludovica" de La Plata; ArgentinaFil: Lopez, Laura Beatriz. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Medicina; ArgentinaFil: Boccio, Jose Ruben. Provincia de Buenos Aires. Ministerio de Salud. Hospital de Niños "Sor María Ludovica" de La Plata; Argentin