• OBJETIVO: Evaluar el valor predictivo del índice de Rockall para resangrado y mortalidad en el paciente con episodio de hemorragia digestiva alta de origen no variceal MATERIALES Y METODOS: Se realizó un estudio de tipo Analítico, Longitudinal y Prospectivo. Fueron escogidos 299 pacientes por muestreo estratificado. El método que se realizó para la recolección de datos consistió en Ficha de Recolección de datos a la llegada al servicio de emergencia elaborada por médicos especialistas de Gastroenterología del Hospital María Auxiliadora. RESULTADOS: Se encontró que el Índice de Rockall tiene un valor predictivo a partir del valor 5 para resangrado con una sensibilidad de 83% y una especificidad de 88% con un área debajo de la curva ROC de 0.87; mientras que para mortalidad tiene el mismo valor predictivo, a partir de 5 con una sensibilidad de 90.2% y especificidad de 78%, y un área bajo la curva COR de 0.88 CONCLUSIONES: De acuerdo a los resultados obtenidos podemos concluir que el índice de Rockall es un instrumento confiable con alto valor predictivo para Resangrando y Mortalidad en pacientes con HDA no variceal durante el periodo Julio 2015 y Marzo 2016

O presente estudo tem por objetivo avaliar as características clinicopatológicas, imunoistoquímicas e moleculares de 513 casos brasileiros de tumor estromal gastrintestinal, incluindo o estudo da expressão imunoistoquímica de CD117, CD34, proteína DOG1, actina de músculo liso, desmina, proteína S-100, antígeno Ki-67, proteína p53, molécula de adesão CD44v3, receptor para fator de crescimento epidérmico, proteína HER2 e receptor para fator de crescimento derivado de plaqueta alfa, além da análise molecular de mutações envolvendo os genes KIT e receptor para fator de crescimento derivado de plaqueta alfa e da pesquisa de amplificação dos genes receptor para fator de crescimento epidérmico e HER2 por hibridização \"in situ\" fluorescente. As características clínicas e morfológicas dos casos estudados não foram diferentes das referidas pela literatura. Houve expressão de CD117 (KIT) em 95,7% dos casos. A proteína DOG1 foi expressa em 85,9% dos tumores, sendo capaz de diagnosticar 20% dos casos com ausência de expressão de CD117 (KIT). O índice de proliferação celular determinado pelo antígeno Ki-67 foi superior nos casos classificados como de alto risco para comportamento biológico agressivo segundo critérios do \"National Institutes of Health\". A expressão da proteína p53 esteve restrita aos casos classificados como de alto risco. Não se observou expressão imunoistoquímica da molécula de adesão CD44v3. A proteína receptora para fator de crescimento epidérmico foi expressa em 84,4% dos casos, porém não se observou superexpressão da proteína HER2. A expressão imunoistoquímica da proteína receptora para fator de crescimento derivado de plaqueta alfa foi observada em 94,4% dos casos estudados, não apresentando relação com o tipo de mutação encontrado. As mutações do gene KIT foram as mais frequentemente observadas, principalmente do éxon 11. Mutações do gene receptor para fator de crescimento derivado de plaqueta alfa foram observadas em 8,1% dos casos, sendo que 54,5% dos casos com ausência de expressão imunoistoquímica de CD117 (KIT) apresentavam mutações nesse gene. A hibridização \"in situ\" fluorescente não demonstrou amplificação dos genes receptor para fator de crescimento epidérmico e HER2 nos tumores estromais gastrintestinais. / The present study presents the clinicopathologic, immunohistochemical and molecular genetic features of 513 Brazilian cases of gastrointestinal stromal tumor, including the immunohistochemical expression of CD117, CD34, DOG1 protein, smooth muscle actin, desmin, S-100 protein, Ki-67 antigen, p53 protein, CD44v3 adhesion molecule, epidermal growth factor receptor, HER2 protein and platelet derived growth factor receptor alpha, the mutation analysis of KIT and platelet-derived growth factor receptor alpha genes, and the investigation of amplification of HER2 and epidermal growth factor receptor genes by fluorescence \"in situ\" hybridization. The clinicopathologic features of Brazilian gastrointestinal stromal tumors do not differ from those published from other countries. CD117 (KIT) was expressed by immunohistochemistry in 95.7% of cases. DOG1 protein was expressed in 85.9% of tumors, being able to establish the diagnosis of GIST in 20% of those cases that were negative for CD117 (KIT). Ki-67 proliferation index was higher in those cases classified as high-risk of aggressive behavior by the National Institutes of Health consensus approach. The immunohistochemical expression of p53 protein was restricted to cases classified as high-risk of aggressive behavior. The adhesion molecule CD44v3 was not expressed in any of the cases. The epidermal growth factor receptor protein was overexpressed in 84.4% of cases, and HER2 protein was not expressed in all cases. The platelet-derived growth factor receptor alpha protein was detected by immunohistochemistry in 94.4% of tumors, and there was no relationship between its expression and the mutation status. KIT mutations were the most frequent, mainly of exon 11. Plateletderived growth factor receptor alpha mutations were found in 8.1% of the cases, and 54.5% of those cases that were negative for CD117 (KIT) had mutations in platelet-derived growth factor receptor alpha gene. Fluorescence \"in situ\" hybridization revealed no amplification of epidermal growth factor receptor and HER2 genes in gastrointestinal stromal tumors.

O presente estudo tem por objetivo avaliar as características clinicopatológicas, imunoistoquímicas e moleculares de 513 casos brasileiros de tumor estromal gastrintestinal, incluindo o estudo da expressão imunoistoquímica de CD117, CD34, proteína DOG1, actina de músculo liso, desmina, proteína S-100, antígeno Ki-67, proteína p53, molécula de adesão CD44v3, receptor para fator de crescimento epidérmico, proteína HER2 e receptor para fator de crescimento derivado de plaqueta alfa, além da análise molecular de mutações envolvendo os genes KIT e receptor para fator de crescimento derivado de plaqueta alfa e da pesquisa de amplificação dos genes receptor para fator de crescimento epidérmico e HER2 por hibridização \"in situ\" fluorescente. As características clínicas e morfológicas dos casos estudados não foram diferentes das referidas pela literatura. Houve expressão de CD117 (KIT) em 95,7% dos casos. A proteína DOG1 foi expressa em 85,9% dos tumores, sendo capaz de diagnosticar 20% dos casos com ausência de expressão de CD117 (KIT). O índice de proliferação celular determinado pelo antígeno Ki-67 foi superior nos casos classificados como de alto risco para comportamento biológico agressivo segundo critérios do \"National Institutes of Health\". A expressão da proteína p53 esteve restrita aos casos classificados como de alto risco. Não se observou expressão imunoistoquímica da molécula de adesão CD44v3. A proteína receptora para fator de crescimento epidérmico foi expressa em 84,4% dos casos, porém não se observou superexpressão da proteína HER2. A expressão imunoistoquímica da proteína receptora para fator de crescimento derivado de plaqueta alfa foi observada em 94,4% dos casos estudados, não apresentando relação com o tipo de mutação encontrado. As mutações do gene KIT foram as mais frequentemente observadas, principalmente do éxon 11. Mutações do gene receptor para fator de crescimento derivado de plaqueta alfa foram observadas em 8,1% dos casos, sendo que 54,5% dos casos com ausência de expressão imunoistoquímica de CD117 (KIT) apresentavam mutações nesse gene. A hibridização \"in situ\" fluorescente não demonstrou amplificação dos genes receptor para fator de crescimento epidérmico e HER2 nos tumores estromais gastrintestinais. / The present study presents the clinicopathologic, immunohistochemical and molecular genetic features of 513 Brazilian cases of gastrointestinal stromal tumor, including the immunohistochemical expression of CD117, CD34, DOG1 protein, smooth muscle actin, desmin, S-100 protein, Ki-67 antigen, p53 protein, CD44v3 adhesion molecule, epidermal growth factor receptor, HER2 protein and platelet derived growth factor receptor alpha, the mutation analysis of KIT and platelet-derived growth factor receptor alpha genes, and the investigation of amplification of HER2 and epidermal growth factor receptor genes by fluorescence \"in situ\" hybridization. The clinicopathologic features of Brazilian gastrointestinal stromal tumors do not differ from those published from other countries. CD117 (KIT) was expressed by immunohistochemistry in 95.7% of cases. DOG1 protein was expressed in 85.9% of tumors, being able to establish the diagnosis of GIST in 20% of those cases that were negative for CD117 (KIT). Ki-67 proliferation index was higher in those cases classified as high-risk of aggressive behavior by the National Institutes of Health consensus approach. The immunohistochemical expression of p53 protein was restricted to cases classified as high-risk of aggressive behavior. The adhesion molecule CD44v3 was not expressed in any of the cases. The epidermal growth factor receptor protein was overexpressed in 84.4% of cases, and HER2 protein was not expressed in all cases. The platelet-derived growth factor receptor alpha protein was detected by immunohistochemistry in 94.4% of tumors, and there was no relationship between its expression and the mutation status. KIT mutations were the most frequent, mainly of exon 11. Plateletderived growth factor receptor alpha mutations were found in 8.1% of the cases, and 54.5% of those cases that were negative for CD117 (KIT) had mutations in platelet-derived growth factor receptor alpha gene. Fluorescence \"in situ\" hybridization revealed no amplification of epidermal growth factor receptor and HER2 genes in gastrointestinal stromal tumors.

Despite the popularity of companion animal ownership in Australia, recent and comprehensive information with regard to the prevalence, epidemiology and public health significance associated with gastrointestinal parasites of pet dogs and cats in Australia is largely lacking. The primary aims of this study were to close this knowledge gap and to evaluate the veterinarian’s perception, awareness and knowledge of GI parasites in their locality, from a veterinary and public health stand-point. This included sourcing information with regard to commonly recommended deworming protocols. The awareness of pet owners regarding parasitic zoonoses and the degree of education provided to them by veterinarians was also determined. A total of 1400 canine and 1063 feline faecal samples were collected from veterinary clinics and refuges from across Australia. The overall prevalence of gastrointestinal parasites in dogs and cats was 23.9% (CI 21.7-26.1) and 18.4% (CI 16.1-20.7), respectively. Overall Giardia duodenalis was the most prevalent parasite in dogs (9.3%, CI 7.8-10.8) followed by hookworm (6.7%, CI 5.4-8.0). Isospora felis was the most prevalent parasite in cats (5.6%, CI 4.2-7.0), followed by Toxocara cati (3.2%, CI 2.1-4.3). A highly sensitive and species-specific PCR-RFLP technique was utilized to differentiate the various hookworm species which can infect dogs and cats directly from eggs in faeces. Ancylostoma ceylanicum was detected for the first time in Australia in 10.9% of the dogs found positive for hookworm. This was a significant finding in terms of the zoonotic risk associated with this parasite. The zoonotic potential of Giardia and Cryptosporidium was investigated by genetically characterising isolates recovered from dogs and cats. All but one of the Giardia isolates successfully genotyped were host specific, indicating a low zoonotic risk. It was hypothesized that the lack of zoonotic Giardia Assemblages was a consequence of there being a low prevalence of Giardia in the human population. The Cryptosporidium recovered from dogs and cats was determined to be Cryptosporidium canis and Cryptosporidium felis respectively, a finding which supports growing evidence that Cryptosporidium in companion animals is of limited public health significance to healthy people. Very few of the veterinarians surveyed in the study routinely discussed the zoonotic potential of pet parasites with clients. Most of the veterinarians recommended the regular prophylactic administration of anthelmintics throughout a pet’s life. The low national prevalence of GI parasites reported is most likely a consequence of the widespread use of anthelmintics by pet owners. There is an over-reliance on anthelmintics by veterinarians to prevent and control parasites and their zoonotic risk. This has resulted in veterinarians becoming complacent about educating pet owners about parasites. A combination of routinely screening faecal samples for parasites, strategic anthelmintic regimes and improved pet owner education is recommended for the control of GI parasites in pet dogs and cats in Australia.

Thesis (M. Phil.)--University of Hong Kong, 2007. / Title proper from title frame. Also available in printed format.

Helicobacter pylori (H.pylori) had been confirmed by the World Health Organization (WHO) as Group 1 carcinogens, in which it has been identified to be related with the development of gastric carcinoma. Gastroesophageal reflux disease (GERD) is less commonly found in Asia, while the number of H.pylori infection is considerably to be higher than that of the Western population. The relationship between H.pylori and GERD still remains ambiguous nowadays. One of the contributing factors affecting the level of gastric secretion might be due to the genetic cause. The aim of this review is to assess whether the current first-line therapy on GERD would be effective or not in relieving the symptoms of the patients with H.pylori infection. / published_or_final_version / Community Medicine / Master / Master of Public Health

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Transpyloric flow is the final step in gastric emptying prior to intestinal absorption of nutrients and medications. The details of this process are still incompletely understood. Transpyloric flow is bi-directional, contrasting with the general perception of solely forward flow implied by studies of gross gastric emptying. The degree to which the patterns of bi-directional transpyloric flow reflect emptying of meals of varied physicochemical composition, its mechanical determinants and effect on delivery of oral medications have been evaluated by the studies presented in this thesis. / Thesis (PhD)--University of South Australia, 2006.