Biomedical subjects

Raúl León Barúa

Publications and source records attributed to Raúl León Barúa.

8 recordsLinked to original sources

PubMedDate not supplied

[Prevalence and relation of dyspepsia to irritable bowel syndrome in a native community of the Peruvian jungle].

INTRODUCTION: Dyspepsia and irritable bowel syndrome (IBS) are two of the most frequent syndromes in gastroenterology. However, very few epidemiological studies have been conducted in Peru and none in the Peruvian Jungle. OBJECTIVES: The objective of this study is to determine the prevalence of dyspepsia and irritable bowel syndrome in a jungle community of Peru and the recurrence percentage of these syndromes. MATERIALS AND METHODS: A sample was taken from 231 persons randomly selected using the "home by home" method, according to the map provided by Punta del Este Medical Center (city of Tarapoto - Department of San Mart n). The persons, considered to best typify the general population of the city, took two tests (Dyspepsia Test and Manning Test) that were previously validated during the months of January through March 1999. RESULTS: The prevalence of dyspepsia was 37.6%, and that of IBS, 22.0%. From those with dyspepsia, 38% had also IBS. From those with IBS, 65% reported dyspepsia symptoms. Prevalence of IBS was higher in individuals with dyspepsia (37.9%) than in individuals without dyspepsia (12.5% p< 0.01). The prevalence of both dyspepsia and IBS decreases as age increases. A statistically significant difference related to ethnicity was found in individuals with IBS. Dyspepsia and ethnicity were associated in 31.4% to individuals having both pathologies (p< 0.0001 and OR=4.28). The dyspepsia/IBS ratio was 1.7/1. CONCLUSION: There is a high prevalence of IBS and dyspepsia in the study population. The high association found between both syndromes may be due to the common etiopathogenic mechanisms they share such as: a visceral hypersensibility due to peripheral or central mechanisms, bowel motility disturbances or parasitosis. Our study suggests that both dyspepsia and IBS are the manifestations of the same digestive disorder, which has not been fully clarified yet.

Adolescent↗

PubMedDate not supplied

[HELICOBACTER PYLORI INFECTION ERRADICATION IN DISPEPTIC PATIENTS WITH AND WITHOUT PEPTIC ULCER]

BACKGROUND: Helicobacter pylori (HP) infection is very prevalent worldwide, and has been associated with the presence of duodenal ulcer, gastric ulcer and chronic active gastritis. It is also speculated that HP may have a role in gastric cancer development. Triple drug schemes have been shown to be the most effective approach to erradicate HP infection. Nevetheless, high rates of resistance against some antibiotics as well as high costs affect the effectiveness of these therapies. The goal of the present study is to assess the effectiveness of the combination of tetracycline, furazolidone and bismuth in erradicating HP, as well as the changes in the histology.METHODS: Patients with diagnosis of HP infection, found in their antral gastric biopsies (hematoxylin and eosin staining (H-E)), were included. They received the following scheme for 10 days: tetracycline 500 mg qid., furazolidone 100 mg qid., and colloidal bismuth subcitrate 120 mg qid. Patients were instructed to come back for follow-up 6 to 8 weeks after starting the therapy. At that time a control upper endoscopy was performed and 3 antral biopsies were taken. Biopsies were stained with H-E and read by experienced pathologists. In both, the biopsy before treatment and the control biopsy, the following parameters were looked for: presence and density of HP; presence, depth and grade of chronic gastritis (lymphoplasmocytic infiltrate); presence and grade of inflammatory activity (polymorphonuclear inflitrate); presence of glandular atrophy; presence, grade (partial or total) and extent (focal or multifocal) of mucinous damage (epithelial damage); presence of intestinal metaplasia; and presence of lymphoid follicles.RESULTS: Fifty-nine patients (30 men and 29 women) completed per protocol. Mean age was 43 +/- 18 (range: 14-73). HP erradication was achieved in 54 patients (91.5%). Control biopsies showed improvement in the following parameters: presence and density of HP (p<0.001); presence, depth and grade of chronic gastritis (p<0.001); presence and grade of inflammatory activity (p<0.001); presence, grade and extent of mucinous damage (p<0.001); and presence of lymphoid follicles (p<0.001). Neither the presence of glandular atrophy nor the presence of intestinal metaplasia showed any significant change. Patients who did not erradicate HP showed no significant difference in any of the parameters.CONCLUSIONS: The triple drug scheme including tetracycline, furazolidone and bismuth is effective in HP erradication. Erradication of HP is followed by an improvement in the following histologic parameters: presence, depth and grade of chronic gastritis (LMN infiltrate); presence and grade of inflammatory activity (PMN infiltrate); presence, grade and extent of mucinous damage; and presence of lymphoid follicles. This scheme is a cost-effective alternative for the therapy of HP infection in low income populations with a high prevalence of infection with this bacteria.

Journal Article↗

PubMedDate not supplied

[HELICOBACTER PYLORI, CHRONIC GASTRITIS, GASTRIC ANDDUODENAL ULCER: STUDY OF 1638 PATIENTS]

We anaylize in patients from high socio economic level the histologic findings of biopsies from the gastric mucosa taken endoscopically. Patients with upper gastrointestinal symptoms were examined with esophagogastroduodenoscopy. In the histologic study we considered: presence of Helicobacter pylori, mucinous damage, displasia, atrophy and intestinal metaplasia. Patients were divided in two groups: those who endoscocopically did not present gastric or duodenal active ulcer, gastric neoplasia or were not gastrectomized or vagotomized and those in which active gastric or duodenal ulcer was found. The first group was comprised of 1406 patients (647 women and 769 men). 57.33% (806) showed presence of Helicobacter pylori in the histologic study. Males presented higher prevalence of the bacteria (57.32% vs 42.68%, p=0.021873). Atrophys was found in 8.25% and was more frequent in patients with H. pylori (78.45% vs 21.55% p=0.0000026) / Intestinal metaplasla was found in 11.24% being related more with the presence of H.pylori (74.68% vs 25.32%, p=0.0000043). In the second group comprised of 232 patients: 192 males (82.7%) 82.75% showed presence of the bacteria. There was not a statistical difference by comparing sex and age vs presence of ulcer.

Journal Article↗

PubMedDate not supplied

[CONTRIBUTION STUDY TO THE EPIDEMIOLOGY OF HELICOBACTERPYLORI IN PERU: ANALYSIS OF 3005 CASES]

Compiling our observations from the last 15 years in regard to the epidemiology of Helicobacter pylori in Perú, we have analized 3005 cases. Studying and comparing the rates of infection among japanese inmigrants living in Perú for more than 10 years, niseis, japanese visitors and peruvians, we found similar rates. According to these results it seems that at least in japaneses there is not any genetic predisposition to acquire the infection. Studying peruvians of different socioeconomic levels, we observed similar rates of infection with the exception of women of high socioeconomic level. It seems that the last group of people is not exposed to the different mechanisms of infection. We found similar rates of infection in patients of low socioeconomic level living in the coast, sierra and jungle. Our studies in children showed that the infection is acquired during early childhood. Therefore in Perú we have not observed an ascending rate of infection according to age as has been described in industrialized countries. Analizing water from 48 sources we found Helicobacter pylori in 24 samples, 20 of them were taken from the municipal source of water. Water seems to be an important vehicle of infection, according to our studies, in children drinking water from different sources.

Journal Article↗

PubMedDate not supplied

[Flatulence].

At present physicians focus their medicine studies in well defined illnesses as peptic ulcer, gastric cancer, ulcerative colitis and so on. However, patients reveal their discomfort to us, that is their symptoms or group of symptoms (syndromes). For this reason, our concern for many years has been the study of symptoms and syndromes. In this review we will be looking at the concepts and information gathered with respect to intestinal gases, clinically known as flatulence.

Abdominal Pain↗

PubMedDate not supplied

[Small intestine bacterial overgrowth in patients with chronic diarrhea and normal control subjects].

The purpose of this study was to investigate the prevalence and meaning of small intestine bacterial overgrowth (SIBO) in patients with chronic diarrhea and normal control subjects. To that effect, a hydrogen breath test was performed using lactulose on 54 patients with chronic diarrhea and 16 normal control subjects. The presence of SIBO was defined as an increase in the hydrogen concentration, of > 20 parts per million above the basal value in any of the breath tests after the ingestion of lactulose. In addition, the logarithms of the areas under the hydrogen concentration curves were calculated.SIBO was present in two (12.5%) of the 16 normal control subjects. The frequency of SIBO was higher in patients with chronic diarrhea (24.1%) than in the normal control subjects; however, this difference was not statistically significant (p:0.27). Finally, the mean + sd of the logarithms of the areas under the hydrogen concentration curves was significantly higher in patients with chronic diarrhea (6.485 + 0.751) than in normal control subjects (6.135 + 0.500) (p<0.05). The results obtained show that SIBO occurs in a certain percentage of the population, without presenting diarrhea. For SIBO to produce diarrhea, it probably requires some additional characteristics. However, it is worth it to suspect and investigate for SIBO in all chronic diarrhea cases.

Adult↗

PubMedDate not supplied

[Viral hepatitis A as a triggering agent of autoimmune hepatitis report of a case and review of literature].

The case of a 61-year-old woman who developed a picture of viral Hepatitis A with an uncomplicated clinical course is reported herein. However, nine months after the diagnosis, the aminotransferases still remained discretely elevated (AST 78 UI/L, ALT 95 UI/L). At that moment, the patient started to present transient arthralgias and markers were requested for autoimmune hepatitis, which turned out positive, besides presenting hypergammaglobulinemia. A liver biopsy was performed showing changes consistent with mild autoimmune hepatitis. It was considered that the case did not warrant treatment with corticosteroids or immunosuppresants and continued to observe the patient, who is asymptomatic until the publishing of this report. To our knowledge, this is the first report in our country of autoimmune hepatitis triggered by a viral Hepatitis A. The case is reported and the literature is being reviewed.

Autoantibodies↗

PubMedDate not supplied

[Relapsing viral hepatitis type A complicated with renal failure].

We report the case of a 42-year old male with an episode of relapsing hepatitis A of cholestatic pattern, which clinic course was complicated by fever, anemia and renal failure, requiring hemodialysis. The occurrence of cryglobulins and diminished complement levels was detected. A kidney biopsy was performed showing evidence of thrombotic microangiopathy. The patient had a good therapeutic response to corticosteroids, although he developed recurrence of fever and a palpable purpuric rush over his lower extremities when dose was reduced. A skin biopsy found leukocytoclastic vasculitis. Symptoms and physical findings improved when therapy with cycloposphamide was started and the dose of corticosteroids was increased. Hepatitis A virus infection usually has a benign course, although complications may occasionally develop. The relapsing form can be seen in 3-20% of the case; it can appear with a cholestatic pattern and most of the time it has a mild clinic development. Unlike hepatitis B, extra-hepatic manifestations are unusual in hepatitis A, and renal manifestations are even more infrequent. Acute renal failure (ARF) in non-fulminating hepatitis A has been reported only occasionally and its etiology remains unclear. Several hypotheses have been proposed, including renal toxicity due to hyperuricemia or increased bilirrubin, cryoglobulinemia, alterations in the renal blood flow due to endotoxemia or peripheral immune complex-mediated damage when hypocomplementemia is found. Kidney biopsy showed evidence of thrombotic microangiopathy, which raised the hypothesis of a Hemolytic Uremic Syndrome (HUS). An association with HUS has been described in a patient with surface antigen for hepatitis B (HBsAg) and anomalies in the hepatic biochemical tests, but as far as we know this is the first case of relapsing hepatitis A associated with a confirmed microangiopathic renal involvement.

Acute Kidney Injury↗