RESUMO
AIM: To establish the most common vacA alleles in Helicobacter pylori (H pylori) strains isolated from Chilean patients and its relationship with gastritis and gastroduodenal ulcers. METHODS: Two hundred and forty five H pylori clinical isolates were obtained from 79 biopsies from Chilean infected patients suffering from gastrointestinal diseases. An average of 2-3 strains per patient was isolated and the vacA genotype was analyzed by PCR and 3% agarose electrophoresis. Some genotypes were checked by DNA sequencing. RESULTS: The most prevalent vacA genotype in Chilean patients was s1b m1 (76%), followed by s1a m1 (21%). In contrast, the s2 m2 genotype was scarcely represented (3%). The s1b m1 genotype was found most frequently linked to gastropathies (P<0.05) rather than ulcers. Ulcers were found more commonly in male and older patients. Curiously, patients living in cities located North and far South of Santiago, the capital and largest Chilean city, carried almost exclusively strains with the s1b m1 genotype. In contrast, patients from Santiago and cities located South of Santiago carried strains with either one or both s1a m1 and s1b m1 genotypes. Regarding the s2 m2 genotype, comparison with GenBank sequences revealed that Chilean s2 sequence was identical to those of Australian, American, and Colombian strains but quite different from those of Alaska and India. CONCLUSION: Differences in geographic distribution of the s and m vacA alleles in Chile and a relationship of s1b m1 genotype with gastritis were found. Sequence data in part support a hispanic origin for the vacA genotype. Asymmetric distribution of genotypes s1b m1 and s2 m2 recedes H Pylori strain distribution in Spain and Portugal.
Assuntos
Alelos , Proteínas de Bactérias/genética , Gastroenteropatias/microbiologia , Helicobacter pylori/genética , Adolescente , Adulto , Idoso , Sequência de Aminoácidos , Proteínas de Bactérias/metabolismo , Criança , Pré-Escolar , Chile , Feminino , Infecções por Helicobacter , Humanos , Masculino , Pessoa de Meia-Idade , Dados de Sequência Molecular , Alinhamento de SequênciaRESUMO
BACKGROUND: Sanitary and socioeconomic changes and the identification of new causative virus, have changed the epidemiology of hepatitis in Chile. AIM: To study the natural history of acute hepatitis caused by virus A, E and non A-E in Chilean adults. PATIENTS AND METHODS: A special study protocol was followed for patients with a clinical picture of acute hepatitis. Anti HAV IgM, anti HBc IgM, anti HEV IgG and IgM and Anti HCV antibodies were determined by ELISA. RESULTS: Fifty nine patients (30 male), aged 15 to 58 years old were studied. Eighty nine percent had jaundice and 50 to 70% had malaise and abdominal pain. Virus A was positive in 80%, virus E in 7%. In 14% of patients, all viral markers were negative. The evolution was typical in 78%, biphasic in 14% and cholestatic in 5%. One patient had a prolonged and one a fulminant course. Mean ALT was 1148 U/l and mean total bilirubin was 5.5 mg/dl. Seventy three percent of cases occurred during early winter and spring and 27% during summer and early autumn. CONCLUSIONS: The main etiology of acute viral hepatitis in Chile is virus A and most cases occur during the rainy season. Clinical features of hepatitis non A-E are similar to enteral transmission forms.
Assuntos
Vírus de Hepatite/isolamento & purificação , Hepatite Viral Humana/virologia , Doença Aguda , Adolescente , Adulto , Chile/epidemiologia , Ensaio de Imunoadsorção Enzimática , Feminino , Hepatite A/epidemiologia , Hepatite A/imunologia , Hepatite A/virologia , Anticorpos Anti-Hepatite/imunologia , Hepatite E/epidemiologia , Hepatite E/imunologia , Hepatite E/virologia , Vírus de Hepatite/imunologia , Hepatite Viral Humana/epidemiologia , Hepatite Viral Humana/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Estações do AnoAssuntos
Doenças Endêmicas , Hepatite E/epidemiologia , Transplante de Rim/estatística & dados numéricos , Diálise Renal/estatística & dados numéricos , Adulto , Idoso , Chile/epidemiologia , Feminino , Hepatite E/transmissão , Vírus da Hepatite E/classificação , Vírus da Hepatite E/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , PrevalênciaRESUMO
Little is known about hepatitis E virus (HEV) prevalence in South American countries. Anti-HEV was studied in 1,773 subjects from 1,360 blood donors of 3 cities in Chile, 72 in health care workers, 241 inmates in state jails, and in 100 Araucanian indians. Anti-HEV was detected in 109 out of 1,360 (8.0%) total donors (6.3%, 6.1%, and 18.8% from the cities of Valdivia, Osorno and Puerto Montt respectively); 9 out of 72 (12.5%) health care workers; 18 out of 241 (7.5%) inmates, and 17 out of 100 (17%) Araucanian indians. Prevalence of anti-HEV was not related to age and sex. Hepatitis E is an endemic infection in some population groups of Southern Chile, associated to environmental pollution, crowding and low socioeconomic level.
Assuntos
Bancos de Sangue/estatística & dados numéricos , Doadores de Sangue/estatística & dados numéricos , Anticorpos Anti-Hepatite/imunologia , Vírus da Hepatite E/imunologia , Hepatite E/epidemiologia , Adolescente , Adulto , Distribuição de Qui-Quadrado , Chile/epidemiologia , Feminino , Anticorpos Anti-Hepatite/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , População Rural , Estudos SoroepidemiológicosRESUMO
We studied the presence of antineutrophil cytoplasmic antibodies in 16 patients with idiopathic ulcerative colitis, using an indirect immunofluorescence technique and specific ELISA for myeloperoxidase and proteinase 3. Twelve patients had an active disease and in ten, antineutrophil cytoplasmic antibodies were positive, with a predominantly perinuclear distribution and without specificity for myeliperoxidase or proteinase 3. These antibodies were negative in the four patients with inactive disease. It is concluded that antineutrophil cytoplasmic antibodies could be serologic indicators of disease activity in patients with ulcerative colitis.
Assuntos
Anticorpos Anticitoplasma de Neutrófilos/sangue , Colite Ulcerativa/sangue , Adulto , Especificidade de Anticorpos , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
A placebo-controlled, double-blind study on the efficacy of a hepatitis A vaccine (SmithKline Beecham Biologicals) was started in a region of Chile in September 1990, using hepatitis B vaccine as control. A total of 260 healthy children, 6-15 years of age, negative for antibody to hepatitis A virus (anti-HAV), antibody to HAV immunoglobulin M (IgM), hepatitis B surface antigen, and antibody to hepatitis B surface and core antigens by ELISA tests within 7 days before vaccination, were randomly assigned to two study groups: 128 children received the vaccine with a yellow label (group 1), and 132 children the vaccine with an orange label (group 2) at months 0, 1 and 6. Blood for serology and transaminase determination was drawn at months 1, 2, 6, 7 and 12. Both vaccines were tolerated equally well and no serious side effects were seen. In group 1 (presumed hepatitis A vaccine group), anti-HAV was detected (20% inhibition was used as the cut-off level) in 122 of 128 children (95.5%) tested at month 1, in 126 of 127 (99.2%) at month 2, in 126 of 127 (99.2%) at month 6 and in 126 of 126 (100%) at month 7. One anti-HAV seroconversion seen at month 1 was associated with presence of anti-HAV IgM and therefore probably represents HAV infection. Geometric mean anti-HAV concentration of the other children was 128, 342, 214 and 2301 mIU/ml at months 1, 2, 6 and 7, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Hepatite A/prevenção & controle , Anticorpos Anti-Hepatite/biossíntese , Hepatovirus/imunologia , Vacinas contra Hepatite Viral , Adolescente , Criança , Chile , Método Duplo-Cego , Feminino , Anticorpos Anti-Hepatite A , Vacinas contra Hepatite A , Anticorpos Anti-Hepatite/sangue , Humanos , Imunoglobulina M/sangue , Masculino , Vacinas de Produtos Inativados/efeitos adversos , Vacinas de Produtos Inativados/imunologia , Vacinas contra Hepatite Viral/efeitos adversos , Vacinas contra Hepatite Viral/imunologiaRESUMO
Over a year period, 60 of 172 patients presenting with upper gastrointestinal bleeding were treated by endoscopic thermocoagulation. Entry criteria included active bleeding (pulsatile or oozing), a visible vessel, sentinel clot or the presence of a pigmented protuberance at the ulcer crater. Hemostatic therapy was performed using the heat probe. The physical status and risk of the patients was estimated according to the ASA classification. Hemostasis was obtained in 17 of 21 patients with pulsatile bleeding (81%), 30 of 30 patients with oozing (100%) and 18 of 18 patients with a visible vessel or a pigmented protuberance in the lesion (100%). Three patients, older than 70 years of age, died. All had pulsatile bleeding from a deep ulcer located at the posterior-inferior wall of the duodenal bulb. They were classified as ASA III (n = 1) or IV (n = 2) with significant concomitant illness. These results suggest that endoscopic thermocoagulation is an effective treatment of active upper gastrointestinal bleeding, especially useful in a group of high risk patients.