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OBJECTIVE: To describe and compare the demographic and social characteristics as well as lifestyles of patients with gastric cancer against patients with other important gastric disorders, who attended at main reference health services in Lima, Peru. METHODS: Case control study, matched by sex and age + 2 years, applying a questionnaire to 96 cases with gastric cancer, and to 96 controls from September 2001 to November 2007. RESULTS: There were no significant differences about ethnicity; marital status; exposure to minerals, wood, and metal dusts; tobacco and alcohol; red meat consumption; salt addition; food temperature. 87, 5% of the control group had lesions in the gastric antrum, and 73% of cases group had a tubular adenocarcinoma (56%) in the gastric antrum. There was no family history of cancer in 85% patients of cases group and 59% of controls, (with significant difference). There were significant differences in low scholarship level of cases, as well as for their mothers and fathers (OR 3.75, 3.9, and 3.49 respectively), fruit or vegetables intake, milk or cheese consumption (minus of once a day) (OR 2, 3, 2, 57 and 2, 9 respectively), type of fuel for cooking (firewood, charcoal, and kerosene OR 5, 25), lack of use of refrigerator (OR 8, 4). CONCLUSIONS: The profile of a gastric cancer patient was to proceed from the Andean zone (high altitude +3000 meters over sea level) and jungle, low education level (low socioeconomic level), low consumption of fruits, vegetables and milk, use of firewood, charcoal, or kerosene to cook, and no use of refrigerator. The most frequent histological diagnosis in the case group was tubular adenocarcinoma.

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OBJETIVO: Describir y comparar las características socio-demográficas y los estilos de vida de pacientes con cáncer gástrico versus un grupo control con otros desórdenes gástricos importantes, en centros de salud de referencia en Lima, Perú. METODOS: Estudio caso-control pareado por sexo y edad +2 años. Tiempo: Setiembre 2001 a noviembre 2007. Encuesta a 96 casos con cáncer gástrico y a 96 controles. RESULTADOS: No hubo diferencias significativas en raza, estado conyugal, exposición a polvo de minerales, polvo de madera o de metales; consumo de alcohol, tabaco, carnes rojas, agregar sal a los alimentos, o temperatura elevada de los mismos. Se identificó lesión en el antro gástrico en 87,5% de los controles y 73% de los casos, siendo el adenocarcinoma tubular el tipo histológico más frecuente entre los casos (56%). No hubo antecedente familiar de cáncer en 85% de los casos y 59% de los controles, con diferencia significativa. En los casos se encontró baja escolaridad en las madres y padres de los casos en los casos (OR 3,9, 3,49 y 3,75, respectivamente), también en el consumo de frutas o vegetales, leche y queso en menos de una vez por día (OR 2,3, 2,57 y 2, 9 respectivamente), así mismo en el tipo de combustible para cocinar (leña, carbón o kerosene OR 5,25) y no usar refrigerador para la conservación de alimentos (OR 8,4). CONCLUSIONES: El perfil de un paciente con cáncer gástrico fue proceder de la sierra (+ 3000 msnm) y selva; condición socioeconómica baja (baja educación); bajo consumo de frutas, vegetales y leche; así como el uso de leña, carbón o kerosene para cocinar y falta de refrigerador para la conservación de los alimentos. El principal diagnóstico histológico entre los casos fue el adenocarcinoma tubular.

OBJECTIVE: To Describe and compare the demographic and social characteristics as well as lifestyles of patients with gastric cancer against patients with other important gastric disorders, who attended at main reference health services in Lima, Peru. METHODS: Case control study, matched by sex and age + 2 years, applying a questionnaire to 96 cases with gastric cancer, and to 96 controls from September 2001 to November 2007. RESULTS: There were no significant differences about ethnicity; marital status; exposure to minerals, wood, and metal dusts; tobacco and alcohol; red meat consumption; salt addition; food temperature. 87, 5% of the control group had lesions in the gastric antrum, and 73% of cases group had a tubular adenocarcinoma (56%) in the gastric antrum. There was no family history of cancer in 85% patients of cases group and 59% of controls, (with significant difference). There were significant differences in low scholarship level of cases, as well as for their mothers and fathers (OR 3.75, 3.9, and 3.49 respectively), fruit or vegetables intake, milk or cheese consumption (minus of once a day) (OR 2, 3, 2, 57 and 2, 9 respectively), type of fuel for cooking (firewood, charcoal, and kerosene OR 5, 25), lack of use of refrigerator (OR 8, 4). CONCLUSIONS: The profile of a gastric cancer patient was to proceed from the Andean zone (high altitude +3000 meters over sea level) and jungle, low education level (low socioeconomic level), low consumption of fruits, vegetables and milk, use of firewood, charcoal, or kerosene to cook, and no use of refrigerator. The most frequent histological diagnosis in the case group was tubular adenocarcinoma.

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Gastric biopsies of the non neoplastic area of 46 patients with gastric cancer and 59 gastric biopsies of dyspeptic patients without gastric cancer were reviewed by one pathologist, without knowing from which group they were coming, to determine the histopathologic findings. The results of both groups were compared. Intestinal metaplasia was found to be significantly higher in gastric cancer patients than in patients without neoplasia (54,3 and 25,4% respectively) (p=0,001). Also in patients with cancer and intestinal metaplasia, this was of the complete type in about 80% of the cases. A number of items were assessed using logistic regression, we found that the presence of complete metaplasia, gastric atrophy and hypertrophy of the mucinogenous vacuole correlates with the presence of gastric cancer (p=0,0159 0,0080 y 0,0280 respectively). H.pylori presence was similar in both groups. The study was done between November 1997 and November 1998 at the Cayetano Heredia National Hospital and the National Institute of Neoplastic Diseases.

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Las biopsias de la mucosa gástrica no neoplásica de 46 pacientes con cáncer gástrico y las biopsias gástricas de 59 pacientes con dispepsia sin cáncer gástrico fueron evaluadas por un mismo patólogo, sin conocer de que grupo procedían, para establecer los hallazgos histopatológicos. Se compararon los resultados de ambos grupos. Se encontró que la presencia de metaplasia intestinal era significativamente mayor en los pacientes con cáncer gástrico que en los pacientes sin neoplasia (54,3 por ciento y 25,4 por ciento respectivamente) (p=0,001). Además en los pacientes con cáncer gástrico con metaplasia intestinal, ésta era metaplasia completa en un 80 por ciento de los casos. Se evaluó un número de variables usando regresión logística, encontrándose que la presencia de metaplasia completa, atrofia gástrica e hipertrofia de la vacuola mucinógena correlacionan con la presencia de cáncer gástrico (p=0,0159 0,0080 y 0,0280 respectivamente ). La presencia de H. pylori fue similar en ambos grupos. El estudio se realizó entre noviembre de 1997 y noviembre de 1998 en el Hospital Nacional Cayetano Heredia y el Instituto Nacional de enfermedades Neoplásicas.

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Clostridium difficile is associated to episodes of diarrhea related to the use of antibiotics in general hospitals. The aim of this study has been to determine the incidence of this complication among the patients admitted in a 400 bed general hospital in Lima, Perú; we registered every day, in all the wards of the hospital, the presence of diarrhea in patients under antibiotic treatment. In every patient with diarrhea we investigated the presence of cytotoxin and cultivated for C. difficile in the feces. Only 25 patients presented diarrhea and none of them showed inflammatory changes in the endoscopic exploration. Only one patient presented positive cytotoxin with negative culture. In the control group of 41 new-born, asymptomatic infants, already on breast-feeding there were 27 (65.8%) culture and/or cytotoxin positive. We conclude that in our adult population colitis due to C. difficile, associated to antibiotic therapy is an infrequent disease.

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