Background: Helicobacter pylori has been extensively studied since 1982 it is estimated that 50% of the world population is affected. The literature lacks studies that show the change of its prevalence in the same population over time. Aim: To compare the prevalence of H. pylori in 10 years interval in a population that was submitted to upper endoscopy in the same endoscopy service. Method: Observational, retrospective and cross-sectional study comparing the prevalence of H. pylori in two samples with 10 years apart (2004 and 2014) who underwent endoscopy with biopsy and urease. Patients were studied in three consecutive months of 2004, compared to three consecutive months of 2014. The total number of patients was 2536, and 1406 in 2004 and 1130 in 2014. Results: There were positive for H. pylori in 17 % of the sample as a whole. There was a significant decrease in the prevalence from 19.3% in 2004 to 14.1% in 2014 (p<0.005). Conclusion: There was a 5.2% reduction in the prevalence of H. pylori comparing two periods of three consecutive months with 10 years apart in two equivalent population samples.

No abstract

No abstract

BACKGROUND: There are lesions that are still being missed in colonoscopy. Many of those could be superficially elevated serrated lesions or depressed ones. AIMS: The aim of this study was to compare the histopathological characteristics of these lesions and their risks for submucosal carcinoma. METHODS: This is a retrospective, cross-sectional, and observational study comparing 217 superficially elevated serrated lesions larger than 5 mm resected by colonoscopies (G1) with 558 depressed lesions (G2). RESULTS: In G1, 217 lesions were found in 12,653 (1.7%) colonoscopies; in G2, 558 lesions were found in 36,174 (1.5%) colonoscopies. In G1, 63.4% were women and in G2, there was no gender predominance. The average size of G1 was 16.2 mm and G2 was 9.2 mm (p<0.001). G1 predominated on the proximal colon and G2 on the distal and rectum (p<0.001). In G1, there were 214 (98.6%) low-grade intramucosal neoplasia and 3 (1.4%) high-grade intramucosal neoplasia. Excluding 126 hyperplastic polyps and considering 91 sessile serrated adenomas in G1, we observed 88 (96.7%) low-grade intramucosal neoplasia and 3 (3.3%) high-grade intramucosal neoplasia; in G2, we observed 417 (74.7%) low-grade intramucosal neoplasia, 113 (20.3%) high-grade intramucosal neoplasia, and 28 (5.0%) submucosal adenocarcinomas (p<0.001). CONCLUSION: Depressed lesions significantly had more high-grade intramucosal neoplasia and more invasive carcinomas in the submucosal layer than superficially elevated serrated lesions and more than superficially elevated sessile serrated adenomas.

We report a case of a 56-year-old man admitted to the Emergency Department of a Hospital in Sao Paulo with dyspnea, hypoxemia and pleural effusion due to pulmonary embolism as the first presenting sign of hepatocellular carcinoma. CT angiography of the chest confirmed bilateral pulmonary embolism with tumor thrombus invasion of the inferior vena cava and right atrium. The patient was not aware of previous chronic liver disease. Anticoagulant therapy with low-molecular weight heparin was administered. Due to a high risk of complications in a cardiovascular surgery intervention, the medical team decided to start palliative treatment for the HCC with sorafenib. Patient was discharged after 5days of anticoagulation without any respiratory complaint, using enoxaparin (1mg/ kg, q12h). Patient was readmitted to hospital 6months after the diagnosis of HCC with acute upper gastrointestinal hemorrhage and died due to its complications. Liver cancer is the sixth most prevalent cancer, and patients with cirrhosis are at highest risk for developing hepatocellular carcinoma. Thus, these patients should be screened with abdominal ultrasound every 6months, aiming a diagnosis in early stages. A therapeutic option for a thrombus that invades inferior vena cava and the right atrium is surgery, but most patients would not tolerate such procedure due to advanced hepatic dysfunction. In a palliative scenario, sorafenib is a first line treatment option.