Our results showed a significant decrease in H. pylori infection rates from children referred for upper gastrointestinal symptoms evaluation from 2002 to 2009, following the H. pylori epidemiologic trend reported in other countries.
Zinc deficiency remains a serious health problem worldwide affecting developed as well as developing countries. Despite the evidence proving that zinc deprivation during the periods of rapid growth negatively affects the cognitive brain as well as sexual development, there are few complete studies carried out in children. The present article proposes a revision of the evidence gathered until now on the relationship existing between zinc deficiency and intellectual and sexual development during the stages of childhood, preadolescence, and adolescence.
To investigate the association between Helicobacter pylori and anemia, a community-based cross-sectional study was conducted among (-0.24-0.11; p = 0.4
BackgroundIdentification of the effect of Helicobacter pylori on the digestive system has given rise to studies of the risk factor of this infection for extra-gastric diseases. It has been proposed that H. pylori may be responsible for iron deficiency, among other risks. The factors that lend biological plausibility to this association include the deficiency in iron absorption by H. pylori-colonized gastric cells, competition for iron between gastric cells and H. pylori, and bleeding through peptic ulcers and other gastric lesions associated with H. pylori 1,2 .Anemia is a major public health problem in developing countries. The main causes of anemia include: dietary iron deficiency; infectious diseases such as malaria, hookworm infections and schistosomiasis; deficiencies of other key micronutrients including folate, vitamin B12 and vitamin A; and inherited conditions that affect red blood cells, such as thalassaemia. Nonetheless, about half of all cases of anemia can be attributed to iron deficiency 3 . Accordingly, if an association between H. pylori and anemia is demonstrated, eradication of this bacterium could become an important public health strategy for controlling anemia in developing countries.The present study was planned to investigate the association between H. pylori colonization and anemia among adult users of the primary health care network in the city of Pelotas, in Southern Brazil.ARTIGO ARTICLE
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 13 C-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 73.5% (95% CI: 69.3; 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 erradication 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.
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