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G Figueroa

Publications and source records attributed to G Figueroa.

At least 19 recordsLinked to original sources
PubMed2002

Prevalence of serum antibodies to Helicobacter pylori VacA and CagA and gastric diseases in Chile.

The objective of this study was to evaluate the prevalence of antibodies to Helicobacter pylori CagA and VacA proteins and correlate this prevalence with gastric diseases in colonised Chileans. The study was performed in 418 adults colonised with H. pylori: 316 with gastroduodenal pathology (152 duodenal ulcer, 14 gastric cancer and 150 gastritis patients) and 102 asymptomatic subjects. Serum IgG antibodies to H. pylori were determined by enzyme immunoassay (EIA). Antibodies to VacA and CagA proteins were detected by Western blotting. In a subgroup of the patients, the vacuolating activity was determined by HeLa cell assay and the CagA product was confirmed by PCR assay. IgG antibodies to both VacA and CagA proteins of H. pylori were found in 270 (85%) of 316 colonised gastric patients and in 72 (71%) of 102 asymptomatic subjects. Colonisation with virulent strains was significantly higher among duodenal ulcer and gastric cancer patients than in gastritis patients or asymptomatic subjects. Infections with VacA+/ CagA+ H. pylori strains is common in Chile but, in contrast to some Asian countries, this phenotype was more prevalent in isolates from patients with more severe gastric pathologies.

Antibodies, Bacterial↗
PubMed2002

Immunoglobulin G antibody response to infection with coccoid forms of Helicobacter pylori.

An increasing number of studies support a potential role for coccoid forms in Helicobacter pylori infection. Evidence for this was obtained through scanning microscopy, genetic analysis for virulence traits, examination of the presence and activity of key enzymes, and other methods. We studied the serum immunoglobulin G responses to coccoid H. pylori forms by enzyme-linked immunosorbent assay (ELISA) and immunoblotting and compared them with those of bacillary cells. Sera from a total of 295 infected individuals were studied; these included sera from 100 patients with duodenal ulcers, 98 patients with nonulcer dyspepsia, 11 patients with gastroduodenal cancer, and 86 asymptomatic individuals. Initially, we characterized and selected coccoid and bacillary antigenic preparations by one-dimensional (1-D) and 2-D gel electrophoresis and immunoblotting. Data showed that coccoid and bacillary preparations with comparable protein contents have similar patterns in 1-D and 2-D electrophoresis gels and antigenic recognition at blotting. These results revealed that coccoid and spiral antigens in ELISA can equally recognize specific antibodies to H. pylori in sera from infected individuals. The analysis of the spiral and coccoid preparations by Western blotting showed no major differences in antigen recognition. No specific bands or profiles associated with a single gastric condition were identified.

Adult↗
PubMed2001

Gastric permeability is not increased in children colonized by CagA-positive strains of Helicobacter pylori.

BACKGROUND: Sucrose permeability has been used as a marker to detect gastric lesions in children. As CagA status of Helicobacter pylori is an important factor in determining the evolution of the gastric lesion, CagA-positive strains being more frequently associated with severe mucosal lesions, the aim of this study was to determine the prevalence of CagA-positive strains in Helicobacter pylori-colonized children and to evaluate whether the sucrose permeability test might discriminate between colonization by CagA-positive or negative strains. PATIENTS AND METHODS: A series of 38 children (11.1+/-3.6 years) who required upper endoscopy for diagnostic purposes were included in the study. Endoscopy was carried out after the sucrose permeability test, and gastric biopsies were obtained for histologic examination, Helicobacter pylori detection by Giemsa staining and CLO-test, and determination of CagA status of the colonizing Helicobacter pylori strains by polymerase chain reaction. RESULTS: Helicobacter pylori was detected in 26 subjects (68.4%) and of these, 16 (61.5%) were colonized by CagA-positive strains. The intensity of the histologic findings was significantly associated with the presence of Helicobacter pylori and with CagA status of the infecting strains (chi2=21.2, p=0.0017). However no significant difference in the urinary excretion of sucrose between children not colonized and children with CagA- negative or positive strains was observed (0.027% [0.012-0.035%]; 0.027% [0.016-0.047%] and 0.026% [0.016-0.038], median [range], respectively; Kruskal-Wallis analysis of variance F=0.75, p=0.69). CONCLUSIONS: These results indicate that in Chile, about 60% of the Helicobacter pylori infected children are colonized by CagA-positive strains, in association with more intense lesions of the gastric mucosa, but that gastric permeability to sucrose does not discriminate between colonization by CagA-negative and positive strains of Helicobacter pylori.

Abdominal Pain↗
PubMed2001

[Is bioethics the Circe of medicine?].

BACKGROUND: Recent development in the biomedical fields have led to considerable moral perplexity, about the rights and duties of health professionals, patients and research subjects. Since about 1970 bioethics have become involved in an ongoing discussion of the complex ethical issues raised by these developments. OBJECTIVE: To review the precise relationship between Nietzsche's ontology and an eventual bioethics. METHOD: The author intends to give a picture of how ontological factors have influenced the beginnings of bioethics. RESULTS: Ethics for Nietzsche symbolizes Circe, the enchantress in Homer's Odyssey. Nietzsche's task is to proclaim the emptiness (devaluation) of all traditional values, thus soliciting a rejection of them. But bioethics must not be content with merely replacing the old values by new ones. v.g. by filling the place left by the supreme values. CONCLUSIONS: Despite the efforts to overcome technic, bioethics remains locked in the subject-ism of which technic is but a consequence. Nietzsche's special insight is to perceive that the interpretation of beings currently prevalent is valueless for it is an interpretation that has returned to values that are precisely without an value at all.

Bioethics↗
PubMed2000

[Application of serology to confirm the eradication of Helicobacter pylori in peptic ulcer patients].

BACKGROUND: Measurement of changes in serum antibodies is an excellent predictor of Helicobacter pylori eradication after antibiotic treatment. AIM: To measure the changes in serum antibody titers to Helicobacter pylori, before and after treatment. MATERIAL AND METHODS: IgG antibodies to H. pylori were prospectively evaluated in 107 duodenal ulcer patients treated either with antibiotics (amoxicillin, metronidazole and bismuth subsalicylate) plus omeprazole or omeprazole alone. IgG antibody levels were determined using an "in house" ELISA in sera from 49 eradicated patients that received quadruple therapy and 58 non-eradicated patients (12 in whom antibiotic therapy failed and 46 that received omeprazole alone). Endoscopy, urease test, microscopy, and culture of gastric biopsies confirmed H. pylori eradication. RESULTS: Patients in whom H. pylori was eradicated, showed a maintained drop in serum antibody titers that ranged from 15%, 62%, 74% to 76% at 28 days, 4, 8 and 12 months respectively. Such reduction was not observed in patients treated with omeprazole. Patients, in whom quadruple therapy failed to eradicate H. pylori, showed a discrete and transient decrease in antibody titers. By the fourth month, patients in whom eradication with quadruple therapy was not achieved, irrespective of whether they received quadruple therapy or omeprazole alone. CONCLUSIONS: A 45% decrease in IgG titer after 4 months is indicative of therapeutic success in H. pylori eradication. Therefore, serology may be useful to monitor the outcome of antibiotic therapy (Rev Méd Chile 2000; 128: 1119-26).

Adult↗
PubMed1999

[At last a humanistic medicine?].

BACKGROUND: We have entered a time of enormous and rapid technological advance. We must pause and reflect on the role of humanism in medicine on that part of our professional calling that denotes the responsibility we have for caring, and the relationship between our art and our science. OBJECTIVE: Humanism is defined as a mode of thought or action in which human interests, values and dignity are taken to be of primary importance. But Heidegger thinks that humanism esteems man too low. The purpose of this article is to review the sense of the word "humanism" in medicine. METHOD: Theories of four general sorts are identified and explained here. RESULTS: Man is inmeasurably more than a rational animal as humanistic medicine postulates. We must pass beyond the traditional interpretations of the nature of man, therefore beyond humanism and humanistic medicines. CONCLUSIONS: It is better to drop the word completely, with the danger of being taken for anti-humanistic, rather than run the risk of having a subject ist interpretation. We must think the nature of man in terms of its exclusive relationship to his being and to Being.

History, 20th Century↗
PubMed1998

[Diagnosis disclosure: the place of beneficence, autonomy and veracity in medical ethics].

OBJECTIVE: The moral doctrine of diagnosis disclosure is derived from a respect for the patient's autonomy as well as the patient's beneficence. These two goals are not necessarily incompatible, but they often lead to different decisions about what information needs to be shared with patients. The ethics of veracity does not prescribe duties, either old or new, but implies a new way of thinking about ethics. METHOD: Theories of the three general sorts just mentioned are identified and explained here. RESULTS: The ethics of veracity as such is limited to unmasking the falsifications of desire that inhabit the moral life. This would meet the moral goals of shared decision-making, because patients could make sense of such data. CONCLUSIONS: Certainly other moral doctrines may turn out to be relevant to the problems discussed in this paper. Nonetheless, they are sufficiently comprehensive to provide an analytical framework by means of which moral problems of diagnosis disclosure can be evaluated. We cannot expect anything else from the enterprise of the ethics of veracity but a critique of authenticity. Its force is that of suspicion, not justification or legitimation, and still less that of prescription.

Diagnosis↗
PubMed1997

Helicobacter pylori infection in Chile.

This article summarizes studies designed to evaluate the role of Helicobacter pylori infection in Chile, described in 21 reports from nine centers in various Chilean regions published between 1985 and 1995. According to their data, H. pylori infection is quite frequent among patients with a variety of gastric conditions, including adults (43%-92%) and children (6%-100%). Levels of specific IgG antibodies to H. pylori are also elevated among patients with duodenal ulcers (100%) and gastritis (86%) as well as asymptomatic adults (75%). Combination therapy with three (but not two) drugs has been proved effective, with clinical improvement, ulcer cure, and H. pylori eradication occurring in well-controlled studies. Available evidence suggests that antibiotic resistance is not a major problem in treatment. The H. pylori reinfection rate is low (4.2% per year), suggesting that combination therapy with three drugs constitutes a cost-effective alternative for treating colonized symptomatic patients. Concurrent preliminary studies revealed that antibodies to VacA but not CagA proteins correlate with disease severity in Chilean patients. It can be concluded that local research assists local administrators of health resources to implement adequate policies to prevent, control, and treat H. pylori-related pathologies.

Chile↗
PubMed1997

[Anxiety disorder and Freud's disease].

OBJECTIVE: The author examined Freud's chest pains and arrhythmia beginning in late 1893 according to the new available data and modern psychiatry. METHOD: Published studies and recent findings were reviewed. The major works of Freud were also considered. Among the issues examined are clinical features, comorbidity, boundaries with others disorders. RESULTS: The findings of this review provided support for the dual diagnosis of panic disorder without agoraphobia and nicotine dependence. CONCLUSIONS: Freud's scientific learning was wide-ranging and his scientific ambition vast. During this period (1893-1897) Freud laid the foundations for the theory of anxiety. He referred to the conditions caused by the dammed-up libido as the actual neuroses. Although the work of Freud has the same aim as the modern DSM-IV, the classification of the Austrian author reflects a different tradition. A discrepancy exists between "anxiety neurosis" (Freud) and "anxiety disorder" (DSM-IV).

Anxiety Disorders↗
PubMed1996

Low H. pylori reinfection rate after triple therapy in Chilean duodenal ulcer patients.

OBJECTIVES: We studied prospectively in a single-blind controlled manner the efficacy of 4-wk triple-antibiotic therapy, with amoxicillin (500 mg p.o., t.i.d.), metronidazole (250 mg p.o., t.i.d.), and bismuth subsalicylate tablets (524 mg p.o., q.i.d.), plus omeprazole (20 mg p.o., q.d.) and compared it with omeprazole (id) in the treatment of duodenal ulcer (DU) patients colonized with Helicobacter pylori. METHODS: One hundred DU patients were entered prospectively over a 12-month period. Fifty-seven of them received triple therapy plus omeprazole and 43 received omeprazole alone. Clinical, endoscopic, and bacteriological evaluations were performed on admission and at 28 days, 4, 8, and 12 months after treatment. RESULTS: After 4-wk treatment (day 28), the ulcer healing rate was high, but there was no significant difference between rates in the triple therapy and omeprazole groups (99% vs. 91%). In contrast, the long-term DU recurrence rate after 12-month follow-up was significantly lower (p > 0.01) for triple therapy (3/57, 5%), compared with omeprazole (34/43, 79%). The difference (higher relapse rate for omeprazole-treated patients) was significant (p < 0.001) by the second evaluation, 4 months after treatment. The eradication rate of H. pylori was also significantly higher among DU patients treated with triple therapy (p < 0.001) during all prospective evaluations, grand mean, 82% (range 82-87%), compared with the omeprazole-treated group, in which there were no cases in which H. pylori was eradicated. Follow-up revealed that 2/47 H. pylori-eradicated patients became reinfected after 1 yr, giving a reinfection rate of 4.2 patient/yr. CONCLUSIONS: Four-week triple-antibiotic therapy plus omeprazole constitutes an adequate alternative for treatment of Chilean DU patients.

Adolescent↗
PubMed1996

[Prospective study of erradication of Helicobacter pylori in patients with duodenal ulcer: analysis of antral and gastric body biopsies].

Omeprazole may not eradicate Helicobacter pylori from the stomach but rather displace it from the antrum to the stomach body. This fact could interfere with colonization studies in patients receiving the drug. The aim of this study was to assess the presence of Helicobacter pylori, defined as a positive urease test, culture or microscopical examination, in antral and gastric body biopsies in patients receiving treatment with omeprazole. Sixty four paired antral and gastric body biopsies obtained at the end of a 28 day course of omeprazole, 62 obtained four months later, 40 obtained eight months later and 23 obtained 12 months later were analyzed. There was a 92% concordance between antral and gastric body biopsies for the presence of Helicobacter pylori. However, nine of the samples obtained at 28 days (14%) were negative for H pylori in the antrum but positive in the gastric body. It is concluded that for early assessment of Helicobacter pylori eradication after omeprazole treatment, paired biopsies of antrum and gastric body are needed.

Duodenal Ulcer↗
PubMed1996

[Congenital hip dislocation associated with spina bifida].

Spina bifida is commonly associated with hydrocephalus and feet malformations, however its association with congenital dislocation of the hip is not well document. We retrospectively analyzed the medical records of 120 children aged 6 months to 15 years old, admited to a rehabilitation center with the diagnosis of spina bifida. Fifty six children (55.4%) had dislocation of the hip (36 of 53 women and 20 of 48 men). These figures are higher than those reported for newborns by the Latin-American Collaborative Stud of Congenital Malformations. We conclude that congenital dislocation of the hip is frequent in children with spina bifida.

Adolescent↗
PubMed1996

[Iron supplementation in Chilean Mapuche infants of the Cautin Province, Chile].

A 1.8 ml iron supplementation of ferrous sulfate is administered for 90 days to 76 Mapuche infants, 12 months of age, male and female, from the rural area of the Cautin province of Chile. The iron nutrition is evaluated before and after the supplementation, through: hemoglobin, haematocrit, transferrin saturation and seric ferritin. Stools test are taken at the infant's home, to confirm the supplement intake and to measure the iron excreted. To study the contained of dietary Fe a Recordatory 24 hour Inquest (RI) is applied moreover a Proximal Chemical Analysis (PCHA) to meal test proceeding from the infant's homes. At 12 months before starting the supplementation, the anemia prevalence was of 28.3%, but it disappear as a result of the intervention. Also 65.3% of the infants showed and increase of 1 g or more on their hemoglobin, which indicates that they were anemic at the beginning of the iron supplementation. By means of this therapeutic test it was find 31% more of anemic infants, indicating more sensibility of this method. The high levels of anemia prevalence are due to the low iron intake, characteristic of the non lactious foods, which according results of the RI reaches an average of 2.8 +/- 1.2 mg of Fe/day, versus 4.8 +/- 4.0 mg of Fe/day according to PCHA. The observed difference between both test showed that there is a process of food environmental contamination, by the use of iron utensils and great soil contact. The high environmental contamination could also be proved by the high iron excretion stools (140 mg of Fe/100 g of stools). This method used to measure the Fe excretion of the supplement, would not be valid in rural population groups with similar characteristics to those of the studied group, because it does not discriminate between the intake and the extremely high environmental contamination. To prevent anemia due to iron absence in infants, it is absolutely necessary to have some iron fortified food starting at 6 months of age, as a complement for breast milk.

Anemia, Iron-Deficiency↗
PubMed1995

Comparison of an oral rice-based electrolyte solution and a glucose-based electrolyte solution in hospitalized infants with diarrheal dehydration.

This randomized trial compared the efficacy of a rice-based (50 g/L) oral rehydration solution with the standard glucose-based WHO/UNICEF solution in the treatment of 100 hospitalized infants, ages 3-18 months, with acute dehydrating diarrhea. The main outcomes examined were stool output and duration of diarrhea. Patients were placed on a "metabolic" bed so that intake and losses could be measured accurately throughout the study. Overall, 89% of patients were successfully rehydrated orally; the rehydration failure rate was similar in the two groups and it was significantly associated with infection by specific E. coli serotypes. Stool output in the first 24 h was 11% lower in the rice group (112 versus 126 ml/kg), but this difference was not significant. Neither stool output in the second 24 h nor total stool output were different between groups. The median duration of diarrhea was 3.8 days in the rice group and 3.9 days in the glucose group (p = NS). Other (secondary) outcomes, such as fluid intake, urine output, emesis losses, weight change, and electrolyte balance were also similar between the two groups. Some evidence of carbohydrate malabsorption was detected in 61% of the rice group versus 45% of the glucose group (p = NS) and was not associated with any particular treatment outcome. These results show that a rice-based oral rehydration solution is as efficacious as, but not better than the standard glucose-based solution in the treatment of infants with acute dehydrating diarrhea not associated with cholera.

Acute Disease↗
PubMed1995

[Why bioethics today?].

Only recently medicine has emphasized the importance of major ethical principles (autonomy, beneficence, justice and non-malificence) and only recently they have come to play an important role in medical and public policy discussions. Until the 70's, medical dilemmas and disagreements were rarely discussed in terms of rights and duties. However, at this point in history, crucial new ideas were introduced, including the notion of Medical Bioethics. What seems important at this stage is to show if Bioethics has made a significant difference in the field of medicine. This article intends to give a picture of how ethical, historical and medical factors have influenced the beginning of Bioethics, in an attempt to determine how much it has been able to fulfill a genuine need.

Bioethics↗
PubMed1994

[Mushroom poisoning in the IX region. Role of Amanita gemmata].

We report four episodes of mushroom poisoning that occurred between 1986 and 1990 in the province of Malleco. Twenty five of 36 individuals who ingested the mushroom became ill; they had an acute gastroenteritis that was followed in 7 by an acute hepatitis and in one by a massive upper gastrointestinal bleeding. Three subjects with fulminant hepatic failure and the subject with the massive bleeding died. Amanita gemmate (strain described as toxic in Chile since 1967) was found in two episodes and Amanita sp in one. The clinical picture is similar to that described for Amanita phaloides. The treatment is symptomatic but penicillin and silymarin may have an antitoxic action. The importance of warning the population about the existence of toxic mushrooms in Chile is emphasized.

Adult↗