Distribution of sulfated glycosaminoglycans in the animal kingdom: widespread occurrence of heparin-like compounds in invertebrates

Sulfated glycosaminoglycans were isolated from 23 species of 13 phyla of invertebrates and characterized by their electrophoretic migration in three different buffer systems coupled with enzymatic degradation using bacterial heparinase, heparitinases and chondroitinase AC. Heparan sulfate is a ubiquitous compound present in all species analyzed whereas chondroitin sulfate was present in 20 species and heparin-like compounds in 12 species of the invertebrates. The heparin-like compounds were purified from the echinoderm Mellita quinquisperforata (sand dollar) and the crustacean Ucides cordatus (crab) with anticoagulant activities of 60 and 52 IU/mg, respectively. Degradation of these heparins with heparinase produced significant amounts of the trisulfated disaccharide typical of mammalian heparins. This was confirmed by 13C-NMR spectroscopy of the crab heparin. An updated phylogenetic tree of the distribution of sulfated glycosaminoglycans in the animal kingdom is also presented.

Design, synthesis, and biological evaluation of fluoronitrophenyl substituted folate analogues as potential inhibitors of GAR transformylase and AICAR transformylase

The examination results of a novel series of potential inhibitors of glycinamide ribonucleotide transformylase (GAR Tfase) and aminoimidazole carboxamide transformylase (AICAR Tfase) are reported. These agents incorporate an electrophilic fluoronitrophenyl group that can potentially react with an active site nucleophile or the substrate GAR/AICAR amine via nucleophilic aromatic substitution.

A study on maternal mortality in Mexico through a qualitative approach

This report presents the main qualitative results of a verbal autopsy study carried out in three states of Mexico, which aimed at identifying the factors associated with maternal mortality that could be subject to modifications through concrete interventions. By reviewing death certificates issued in 1995, it was possible to identify 164 households where a maternal death had occurred. One hundred forty-five of these households were visited, and a precoded questionnaire was completed to explore socioeconomic and living conditions, as well as causes of death. An open-ended question to prompt the relatives to narrate all the facts that led to the maternal deaths was included in the questionnaire. This study presents an analysis of that question, focusing on the delays in the care-seeking process and organized according to the model of the three delays: in deciding to seek care, in reaching a care facility, and in actually receiving care after arrival. Additionally, problems related to quality of care are examined. For analysis of the accounts, structural, interactional/community, and subjective variables were identified that allowed refining of our understanding of the problem of maternal deaths. Finally, based on the findings of the study, this article presents a series of recommendations, highlighting that interventions should address the early stages of a complication and focus on decreasing the various forms of inequality (gender and socioeconomic) associated with the occurrence of maternal deaths.

Self-care strategies for symptom management in patients with chronic heart failure

BACKGROUND

The troublesome symptoms experienced by patients with chronic heart failure are associated with diminished quality of life, frequent hospitalizations, and mortality.

OBJECTIVES

To describe the symptoms experienced by patients with heart failure, to detail the self-care strategies used by these patients in managing their symptoms, and to categorize the self-care strategies.

METHODS

Six focus groups were used with 23 patients who had heart failure, along with six focus groups with 18 family members of the patients. Data analysis was performed by transcription of audiotape recordings of the group sessions and review of field notes.

RESULTS

The patients reported a large number of troublesome symptoms, many consistent with past empirical findings, but some not reported in previous studies. Self-care strategies to manage the symptoms clustered into 11 categories.

CONCLUSIONS

Results from this study provided direction for future studies to (a) identify the prevalence, severity, and etiologies of the commonly reported symptoms, particularly cognitive impairment, loss of balance, and depression; (b) evaluate the emotions reported by women with heart failure; and (c) test the strategies as part of an intervention program to improve symptom management in patients with heart failure.

Regulation of (1-3)-beta-glucan-stimulated Ca(2+) influx by protein kinase C in NR8383 alveolar macrophages

Stimulation of (1-3)-beta-glucan receptors results in Ca(2+) influx through receptor-operated channels in alveolar macrophages (AMs), but the mechanism(s) regulating Ca(2+) influx is still undefined. In this study we investigated the role of protein kinase C (PKC) regulation of Ca(2+) influx in the NR8383 AM cell line using the particulate (1-3)-beta-glucan receptor agonist zymosan. PKC inhibition with calphostin C (CC) or bisindolymaleimide I (BSM) significantly reduced zymosan-induced Ca(2+) influx, whereas activation of PKC with phorbol-12-myristate 13-acetate (PMA) or 1, 2-dioctanoyl-sn-glycerol (DOG) mimicked zymosan, inducing a concentration-dependent Ca(2+) influx. This influx was dependent on extracellular Ca(2+) and inhibited by the receptor-operated Ca(2+) channel blocker SK&F96365, indicating that zymosan and PKC activate Ca(2+) influx through a similar pathway. NR8383 AMs expressed one new PKC isoform (delta) and two atypical PKC isoforms (iota and lambda), but conventional PKC isoforms were not present. Stimulation with zymosan resulted in a translocation of PKC-delta from the cytosol to the membrane fraction. Furthermore, inhibition of protein tyrosine kinases (PTKs) with genistein prevented zymosan-stimulated Ca(2+) influx and PKC-delta translocation. These results suggest that PKC-delta plays a critical role in regulating (1-3)-beta-glucan receptor activated Ca(2+) influx in NR8383 AMs and PKC-delta translocation is possibly dependent on PTK activity.

Takayasu's arteritis associated with Crohn's disease. Report of a case

The authors report a rare case of Takayasu's arteritis with aortic arch and abdominal aorta involvement associated with Crohn's disease of the colon which both occurred in a young female patient. The coexistence of two immune mediated diseases in the same subject is unusual for they are generally considered to be independent of each other, however a hypothesis of their possible interrelationship is put forward.

On-line ion-pair solid-phase extraction-liquid chromatography-mass spectrometry for the analysis of quaternary ammonium herbicides

An ion-pair on-line solid-phase extraction procedure using C8 extraction disks, suitable for liquid chromatography-mass spectrometry analysis is developed to determine quaternary ammonium herbicides (quats) in water samples. The separation of these compounds was performed using ion-pair chromatography with heptafluorobutyric acid (15 mM, pH 3.3) and acetonitrile gradient elution. Detection was carried out using a quadrupole mass spectrometer. Water sample volumes up to 50 ml can be preconcentrated with recoveries higher than 70%. Good precision and accuracy (day-to-day and run-to-run) were obtained and the detection limits ranged from 6 to 85 ng l(-1). The proposed on-line ion-pair solid-phase method enables compliance with European Community directives for drinking waters (100 ng l(-1)).

[Takayasu's arteritis]

A brief review of Takayasu's Arteritis (TA), a chronic granulomatous arteritis that mainly affects the aorta and its major branches, is made. The various ethiopathogenetic mechanisms which may give origin to the vascular damage and its pathologic pattern are described. TA is a more widespread disease than previously stated, it is not exclusive of young women of Japanese origin but it is actually present worldwide irrespective of age and with variegated patterns of clinical and angiographic presentation. However, two main forms may be identified: the Japanese form in which prevails the aortic arch involvement and the Indian form in which vasculitis is present in abdominal aorta and its branches (above all the renal arteries) with an upright extension to the thoracic aorta and a protean clinical picture with a more systemic spectrum. The new clinical and angiographic criteria for TA definition are reviewed and stressed.

Structural features and bleeding activity of commercial low molecular weight heparins: neutralization by ATP and protamine

Differences in the structure of three low molecular weight heparins (LMWHs) have been observed by applying physico-chemical methods as well as enzymatic degradation with bacterial heparinase and heparitinase II. The production of enoxaparin maintains the internal structure of the parent heparin with the exception of the unsaturated nonreducing end. In contrast, the production of dalteparin and nadroparin removes part of their nonsulfated uronic acid residues and, unlike enoxaparin and unfractionated heparin (UFH), these LMWHs also contain regions that remain resistant to the action of heparitinase II. Enoxaparin has a lower molecular weight distribution than dalteparin and nadroparin and is composed of at least four discrete molecular weight populations. A rat-tail model demonstrated that LMWHs applied topically or injected intravenously had a lower bleeding potency when compared with UFH treatment. The bleeding potencies of the different LMWHs were similar. Furthermore, adenosine triphosphate (ATP) completely neutralized bleeding caused by LMWHs and UFH in the animal model when applied topically and significantly reduced bleeding in heparinized surgical patients undergoing cardiopulmonary bypass surgery.

A case of neurofibromatosis type 1 with an aldosterone-producing adenoma of the adrenal

Neurofibromatosis type 1 is a phacomatosis. Neurofibromas are the most common tumours associated with the disease, and along with other tumours, make neurofibromatosis type 1 the most common tumour predisposing syndrome in humans. Hypertension may be coincidental, but at least two specific neurofibromatosis related causes must be considered, namely neurofibromatous involvement of the renal artery and pheochromocytoma. We have described the first known case of a patient with neurofibromatosis type 1 who developed hypertension due to an aldosterone-producing adenoma of the adrenal. The question of whether this association was coincidental or due to the tumour predisposition of neurofibromatosis type 1 was debated.

Structural features and anticoagulant activities of a novel natural low molecular weight heparin from the shrimp Penaeus brasiliensis

A natural low molecular weight heparin (8.5 kDa), with an anticoagulant activity of 95 IU/mg by the USP assay, was isolated from the shrimp Penaeus brasiliensis. The crustacean heparin was susceptible to both heparinase and heparitinase II from Flavobacterium heparinum forming tri- and di-sulfated disaccharides as the mammalian heparins. (13)C and (1)H NMR spectroscopy revealed that the shrimp heparin was enriched in both glucuronic and non-sulfated iduronic acid residues. The in vitro anticlotting activities in different steps of the coagulation cascade have shown that its anticoagulant action is mainly exerted through the inhibition of factor Xa and heparin cofactor II-mediated inhibition of thrombin. The shrimp heparin has also a potent in vivo antithrombotic activity comparable to the mammalian low molecular weight heparins.

New insights on the specificity of heparin and heparan sulfate lyases from Flavobacterium heparinum revealed by the use of synthetic derivatives of K5 polysaccharide from E. coli and 2-O-desulfated heparin

The capsular polysaccharide from E. Coli, strain K5 composed of ...-->4)beta-D-GlcA(1-->4)alpha-D-GlcNAc(1-->4)beta-D-GlcA (1-->..., chemically modified K5 polysaccharides, bearing sulfates at C-2 and C-6 of the hexosamine moiety and at the C-2 of the glucuronic acid residues as well as 2-O desulfated heparin were used as substrates to study the specificity of heparitinases I and II and heparinase from Flavobacterium heparinum. The natural K5 polysaccharide was susceptible only to heparitinase I forming deltaU-GlcNAc. N-deacetylated, N-sulfated K5 became susceptible to both heparitinases I and II producing deltaU-GlcNS. The K5 polysaccharides containing sulfate at the C-2 and C-6 positions of the hexosamine moiety and C-2 position of the glucuronic acid residues were susceptible only to heparitinase II producing deltaU-GlcNS,6S and deltaU,2S-GlcNS,6S respectively. These combined results led to the conclusion that the sulfate at C-6 position of the glucosamine is impeditive for the action of heparitinase I and that heparitinase II requires at least a C-2 or a C-6 sulfate in the glucosamine residues of the substrate for its activity. Iduronic acid-2-O-desulfated heparin was susceptible only to heparitinase II producing deltaU-GlcNS,6S. All the modified K5 polysaccharides as well as the desulfated heparin were not substrates for heparinase. This led to the conclusion that heparitinase II acts upon linkages containing non-sulfated iduronic acid residues and that heparinase requires C-2 sulfated iduronic acid residues for its activity.

Heparan sulfates and heparins: similar compounds performing the same functions in vertebrates and invertebrates?

The distribution and structure of heparan sulfate and heparin are briefly reviewed. Heparan sulfate is a ubiquitous compound of animal cells whose structure has been maintained throughout evolution, showing an enormous variability regarding the relative amounts of its disaccharide units. Heparin, on the other hand, is present only in a few tissues and species of the animal kingdom and in the form of granules inside organelles in the cytoplasm of special cells. Thus, the distribution as well as the main structural features of the molecule, including its main disaccharide unit, have been maintained through evolution. These and other studies led to the proposal that heparan sulfate may be involved in the cell-cell recognition phenomena and control of cell growth, whereas heparin may be involved in defense mechanisms against bacteria and other foreign materials. All indications obtained thus far suggest that these molecules perform the same functions in vertebrates and invertebrates.

Barriers to early detection of cervical-uterine cancer in Mexico

In Mexico, a woman dies of cervical-uterine cancer every 2 hours, indicating a low impact by the national program for early detection of this cancer, principally because of problems related to quality and coverage. Through a qualitative study, we identified the principal barriers to use of the detection program from the point of view of actual and potential program users. Four focus groups were organized in standard conditions in Mexico City (urban, developed) and in the southern state of Oaxaca (rural, economically disadvantaged area). Participants were either women with at least one previous Papanicolaou (Pap) test or women who had never had the test. Barriers to Pap test use included (1) lack of knowledge about cervical-uterine cancer etiology, (2) not knowing that the Pap test exists, (3) the conception that cancer is an inevitably fatal disease, (4) problems in doctor/medical institution-patient relationships, (5) giving priority to unmet needs related to extreme poverty, (6) opposition by the male sexual partner, (7) rejection of the pelvic examination, (8) long waits for sample collection and receiving results, and (9) perceived high costs for care. To increase coverage of the early detection program for cervical-uterine cancer in Mexico, the needs, perceptions, and beliefs of women and their partners must be taken into account when developing policy and planning, given the role these factors play in the decision-making process that leads to their participation or nonparticipation in this program.

Complete resolution of post-traumatic high-flow priapism with conservative treatment

The most frequent cause of high-flow priapism is penile or perineal closed trauma with laceration of the cavernous artery and the formation of an arterial-lacunar fistula. We present the case of a high-flow priapism due to closed perineal trauma and damage to the left cavernous artery which completely resolved following conservative treatment. The case was documented by duplex Doppler ultrasound and selective pudendal arteriogram before and after resolution.

[Tularemia: considerations on a new case in the Monte Amiata]

One sporadic case of tularemia induced by direct contact with an infected hare is described. Human epidemiological data of the last ten years in Tuscany, emphasize that this infection, although at low incidence, shows the presence and persistence of Francisella tularensis in the animals and the ensuing transmission to humans so that it continues to be responsible for significant morbididy in "at risk" territories. Difficulties in the differential diagnosis, above all for glandular and pharyngeal forms, are reviewed.

Ion-pair liquid chromatography--atmospheric pressure ionization mass spectrometry for the determination of quaternary ammonium herbicides

High-performance liquid chromatography coupled with atmospheric pressure ionization mass spectrometry (electrospray and atmospheric pressure chemical ionization) has been used to characterize some quaternary ammonium herbicides (quats). The separation of these compounds was carried out using ion-pair chromatography with heptafluorobutyric acid (15 mM, pH 3.3) and acetonitrile gradient elution for successful coupling to mass spectrometry. Detection limits down to 0.1-4 micrograms l-1 were obtained for spiked tap water following a preconcentration step. Good reproducibilities (day-to-day and run-to-run) were also obtained.

Prevalence of hepatitis viruses in an anti-human immunodeficiency virus-positive population from Argentina. A multicentre study

The objectives of this study were to investigate the prevalence of infections with hepatotrophic viruses in an anti-human immunodeficiency virus (HIV)-positive population from Buenos Aires and to compare it among the main risk groups for HIV infection. Four hundred and eighty-four consecutive patients attending the HIV outpatients clinic were studied: 359 men and 125 women, median age 29 years (range 16-67 years); 35.5% had presented acquired immune deficiency syndrome (AIDS)-defining conditions. Two hundred and thirty-four patients were intravenous drug users (IVDU), 99 had homosexual and 142 heterosexual preference, seven had received blood transfusions and two had no risk factors. Hepatitis B surface antigen (HBsAg), and antibodies to hepatitis B core antigen (HBcAb) and to hepatitis C virus (anti-HCV) were investigated in all patients; antibodies to HBsAg (HBsAb) and IgG antibodies to hepatitis D virus (anti-HDV) in all HBcAb-positive patients; hepatitis B e antigen and antibodies to HBeAg (HBeAg) in all HBsAg-positive patients; IgG antibodies to hepatitis A virus (anti-HAV) in the first 307 patients; and IgG antibodies to hepatitis E virus (anti-HEV) in the first 91 patients. As control groups, contemporary voluntary blood donors were studied for prevalence of HAV, HBV, HCV and HEV. The percentages of HBcAb, HBsAg, anti-HCV and anti-HEV (58.5, 14.5, 58.5 and 6.6%, respectively) were significantly higher in anti-HIV-positive patients than in control groups (3.2, 0.5, 1.0 and 1.8%, respectively) (P = 0.000). The prevalence of HBcAb was significantly higher in IVDU (72.6%) than in heterosexuals (33.8%) (P = 0.0001) and in homosexuals (59.6%) (P = 0.0189). The percentage of HBsAg was significantly higher in IVDU (19.2%) than in heterosexuals (6.3%) (P = 0.0004). Anti-HCV was significantly higher in IVDU (92.3%) than in homosexuals (14.1%) and in heterosexuals (33.1%) (P = 0.000 in both cases). The prevalence of anti-HDV was relatively low (1.9%). There was no difference in the percentage of anti-HAV between HIV-positive and negative subjects. In conclusion, there is a high prevalence of HBV and HCV infections in HIV-positive patients from our area. Drug use is the main route of transmission, but prevalence of HCV in patients with, probably, sexually acquired HIV infection is also higher than in the control group. The increased prevalence of HEV infection in HIV-positive individuals is another provocative finding that warrants further study.

Family responses to HIV/AIDS in Mexico

This paper presents findings from a qualitative study of household and community responses to HIV/AIDS in Mexico. Fieldwork took place in two contrasting settings: (a) Ciudad Netzahualcóyotl, a socially marginalized urban community and (b) the homosexual community of Mexico City, a sexually marginalized social network. 113 in-depth interviews were conducted with people with HIV/AIDS, their relatives and members of their social networks. This paper describes findings from interviews conducted with family members of persons with AIDS. Four stages of response are identified and characterized within each community: (i) life before AIDS, (ii) life during the discovery of AIDS, (iii) living with a person with AIDS and (iv) surviving those who have died from AIDS. The social marginalization of both communities is central in explaining how families respond to the disease. In Ciudad Netzahualcoyotl, social support derives from a local culture of kinship. In the gay community, on the other hand, solidarity arises out of friendship. Between social support and discrimination, many more "ambivalent" behaviours (neither fully supportive nor discriminating) are displayed by family members and friends. Fear, pre-existing family conflicts and prejudice nurture these negative responses. Family responses and the processes to which they give rise, also differ depending on whether or not a male or female household member is affected. Policy recommendations are made concerning how best to promote positive family and household responses to persons with HIV/AIDS and how to inhibit negative ones.

AIDS-related illness trajectories in Mexico: findings from a qualitative study in two marginalized communities

This paper describes findings from a recent study examining how people affected directly and indirectly by the HIV/AIDS epidemic cope with HIV-related illness in Mexico. One-hundred-and-thirteen in-depth interviews were conducted with key informants in two contrasting communities: Ciudad Netzahualcóyotl (an economically marginalized community) and the gay community in Mexico City (a sexually marginalized community). This paper describes the AIDS-related wellness/illness careers or trajectories followed by individuals in both communities, and identifies critical points for material and emotional intervention. This career comprises four stages: (1) life before infection; (2) life surrounding the discovery of seropositivity; (3) living as an HIV-positive person; and (4) facing death. Comparisons are drawn between the processes of adjustment and coping found in both communities. In Ciudad Netzahualcóyotl, wellness/illness careers are closely linked to prevailing poverty and oppression, as well as the sense of urgency in which local people live their lives. In the case of the gay community, wellness/illness careers are associated with the intolerance and social repression faced by homosexual men. The paper concludes by suggesting possible interventions to improve the lives of people with HIV/AIDS in Mexico today.

Hepatitis C virus genotypes and the influence of the induction of immunosuppression with anti-thymocyte globulin (ATG) on chronic hepatitis in renal graft recipients

Hepatitis C virus (HCV) exhibits a dramatic genetic variability and several mechanisms of immunological response are unable to control hepatic and extrahepatic replication. Genotype 1 b is associated with more severe clinical manifestations and is less responsive to interferon. In addition, we have reported an increase of HCV RNA viral load after renal transplantation. Anti-thymocyte globulin (ATG) is supposed to increase viral replication and liver dysfunction in chronically infected renal graft recipients. We evaluated the genotype profile in HCV+ patients of our Renal Transplant Unit and studied the effects of ATG, as part of the induction of immunosuppression, on viral load and liver enzymes abnormalities. From 726 renal graft recipients, 104 patients, with a mean follow up of 3.9 +/- 2.9 years, were anti-HCV+ by ELISA II. HCV RNA was measured by quantitative PCR. We correlated the viral load and biochemical liver parameters with genotype, exposure to ATG as induction therapy, early acute rejection episode and the duration of infection. Of the 81 patients tested, 72% were viraemic and genotype 1 b was the predominant viral strain (66%). The majority of these patients (65%) were coinfected by two or more strains. There was no correlation between HCV RNA blood levels and liver enzymes. We did not find higher viral load with genotype 1 b infection (68 +/- 88 mEq/ml vs 75.8 +/- 123 mEq/ml in the others) nor with ATG induction therapy (43.5 +/- 71.3 mEq/ml vs 64.1 +/- 110.5 mEq/ml). Early acute rejection and longer follow up were not associated with higher levels of HCV RNA. The biochemical liver profile showed no relationship with the variables studied. We concluded that genotype 1 b is the predominant strain in our HCV+ population and there is a great prevalence of coinfection with several genotypes. Our results did not confirm a deleterious effect of the use of ATG as induction therapy in these HCV-infected patients. Prospective randomised studies with liver biopsy evaluation are needed to answer more fully the remaining questions about the best immunosuppressive therapy in renal graft recipients with chronic HCV infection.

Research notes on social order and subjectivity: individuals' experience of susto and fallen fontanelle in a rural community in central Mexico

Disciplines such as sociology and anthropology have showed that the experience of illness, is above all, a social product, that is, that social factors of different kinds play a central role in shaping individuals' subjectivity. This paper refers to the case of Ocuituco, a rural town of central Mexico. The article presents some of the results achieved through an interpretive sociological study of individuals' subjective experience of traditional illnesses such as susto, soul-loss, and fallen fontanelle. The aim is to analyze how Ocuituco's inhabitants attach meaning to, interpret, and experience these illnesses. The main point being made is that the subjective experience of traditional illnesses is shaped both by the cultural background of individuals, and by the sociological features of the setting where these individuals live. Data are interpreted in connection both to structural factors (poverty, medicalization, and patriarchy), and to the main traits that characterize individuals' view of their world: a sense of uncertainty, a sense of the unexpected as being normal, a sense of being oppressed, a familiarity with a patriarchal order. It is shown that both susto and fallen fontanelle are belief systems which allow individuals to interpret their circumstances and attach meaning to their problematic everyday life.

[Hepatitis A virus infection in children in Argentina: a pilot study]

The severity and/or the prognostic of infections with the hepatitis A virus (HAV) is related to the age at which the infection occurs. Since transmission of the virus occurs by the fecal-oral route, the prevalence and age-relate incidence of infection is determined by the adequacy of sanitation hygienic measures and the socio economic level of exposed populations. Thus, the disease is having an increasing impact in developing countries with improving sanitary standards whereas inhabitants of industrialized countries are particularly at risk while visiting under-developed countries. We have established a cooperative group for the serologic study of children range between six months to ten years old, without sintomatology of acute hepatitis. The patients live in Buenos Aires, San Justo, Trelew, Rosario and Tucumán cities. We studied 3699 children. The specific Ab-antiHAV IgG were measured by enzyme immunoassay with commercial available kits (Organon and-or Abbott). The variable of study were age, sex and water quality.

RESULTS

45.19% were of San Justo, 26.15% of Rosario, 13% of Buenos Aires, 8.37% of Trelew and 7.29% of Tucumán. We observed the highest of possibility percentage (%POS) in Tucumán (81.4%), followed by San Justo (57.8%), Rosario (46.5%), Trelew (41.99%) and Buenos Aires (29.4%). In all the cities the lowest %POS was found in children under three years old. Between three and six years old the results were variable and an increase in %POS was observed related to the growth. The global %POS was 51.56%.

CONCLUSIONS

This study confirms Argentina as a high endemic country for HAV infection. A global vaccination program is the only strategy that has the potential to prevent recurrent epidemics of hepatitis A and its erradication.

Risk of Helicobacter pylori transmission by upper gastrointestinal endoscopy

BACKGROUND

Upper gastrointestinal endoscopy has been reported as a risk factor for the transmission of Helicobacter pylori. The aim of this study was to evaluate the possibility of transmission of H. pylori infection by upper gastrointestinal endoscopy in patients who had previously had such procedures in a low disinfection level environment.

METHODS

The study included 1082 patients. Patients that had undergone upper gastrointestinal endoscopy or were treated with antibiotics 15 days before the index endoscopy were excluded. H. pylori infection was diagnosed by ultra-rapid urease test. Variables analyzed were age, gender, type of dyspepsia (organic or functional), and the number of previous upper gastrointestinal endoscopies.

RESULTS

Overall prevalence of H. pylori infection was 60%. Patients ranged in age from 13 to 94 years (mean = 45.8, SD = 15.7) and the number of previous upper gastrointestinal endoscopies ranged from 0 to 20 (mean = 1.5, SD = 2.4). In 53.3% of the patients, upper gastrointestinal endoscopy revealed some mucosal lesion (organic dyspepsia). Prevalence of H. pylori infection was higher in patients with organic rather than functional dyspepsia (71.1% vs. 47.1%, p < 0.001). There was no statistically significant difference in the mean number of upper gastrointestinal endoscopies in patients with and without H. pylori infection.

CONCLUSIONS

We concluded that there was no association between history of upper gastrointestinal endoscopy and current H. pylori infection in this study population.