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      ANEMIA ASOCIADA A INFECCIÓN POR HELICOBACTER PYLORI EN ESTUDIANTES UNIVERSITARIOS Translated title: ANEMIA ASSOCIATED WITH HELICOBACTER PYLORI INFECTION IN UNIVERSITY STUDENTS

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          Abstract

          INTRODUCCIÓN: La anemia se considera una entidad de mayor prevalencia en países en vías de desarrollo, teniendo como causas principales la falta de ingesta nutricional: hierro, ácido fólico, vitamina B12. La anemia ferropénica es la causa más frecuente y afecta en su mayoría a mujeres en edad fértil como en la postmenopausia. Además se ha asociado a Helicobacter pylori, como factor de riesgo para anemia ferropénica. OBJETIVO. Determinar la asociación que existe entre la anemia y Helicobacter pylori como factor de riesgo en los estudiantes de la Universidad Peruana Unión en el año 2014. MATERIALES Y METODO: Estudio de casos y controles. Este trabajo se llevó a cabo en estudiantes de la Universidad Peruana Unión. Se obtuvo la base de datos de estudiantes atendidos en la Clínica Good Hope, con los diagnósticos de anemia ferropénica, seleccionados por medio de un muestreo aleatorio simple determinando el grupo caso de 40 personas con anemia (n=40) y 80 personas sin diagnóstico de anemia siendo el grupo control. Se aplicó una encuesta con las variables de interés para la descripción de la población y el análisis de muestra sanguínea para el hematocrito, hemoglobina (en 48 personas para confirmar los casos y controles) y la prueba rápida anti-Helicobacter pylori. RESULTADOS: Se determinó un odds ratio entre anemia y Helicobacter pylori de 3,8; un chi cuadrado de 10,12 y una p=0,001. Este resultado rechaza la hipótesis nula de independencia de las variables y se comprueba la asociación antes propuesta. DISCUSIÓN: Helicobacter pylori es un factor de riesgo asociado a la anemia ferropénica, aunque se requiere más estudios en nuestra población. CONCLUSIONES. Helicobacter pylori es un factor de riesgo asociado con anemia, aunque se requieren más estudios en la población de esta investigación.

          Translated abstract

          INTRODUCTION: Anemia is considered an entity of greater prevalence in developing countries, having as main causes the lack of nutritional intake: iron, folic acid, vitamin B12. Iron deficiency anemia is the most frequent cause and affects mostly women of childbearing age as in postmenopause. It has also been associated with Helicobacter pylori as a risk factor for iron deficiency anemia. OBJETIVE. To determine the association that exists between anemia and Helicobacter pylori as a risk factor in the students of the Peruvian Unión University in 2014. MATERIAL AND METHOD: Cases and controls study. This work was carried out on students of the Union Peruvian University. The database of students attended at the Good Hope Clinic was obtained, with the diagnoses of iron-deficiency anemia, selected by means of a simple random sampling, determining the group of 40 people with anemia (n = 40) and 80 people without diagnosis of anemia being the control group. A survey was applied with the variables of interest for the description of the population and the blood sample analysis for the hematocrit, hemoglobin (in 48 people to confirm the cases and controls) and the rapid anti-Helicobacter pylori test. RESULTS: An odds ratio between anemia and Helicobacter pylori of 38 was determined; a square chi of 10.12 and a p=0.001. This result rejects the null hypothesis of independence of the variables and the previously proposed association is checked. DISCUSSION: Helicobacter pylori is a risk factor associated with iron deficiency anemia, although more studies are required in our population. CONCLUSIONES: Helicobacter pylori is a risk factor associated with anemia, although more studies are required in the population of this research.

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          Randomized placebo-controlled trial of Helicobacter pylori eradication for iron-deficiency anemia in preadolescent children and adolescents.

          A few cases relating H. pylori infection to iron-deficiency anemia have been described recently. We investigated the role of H. pylori infection in iron-deficiency anemia in preadolescent children and adolescents. We conducted a double-blind, placebo-controlled therapeutic trial in 43 subjects (mean age, 15.4 years) with iron-deficiency anemia. Endoscopy was performed, and biopsy specimens were examined by urease test and histological analysis. Twenty-two of 25 H. pylori-positive patients were assigned randomly to three groups. Group A patients were given oral ferrous sulfate and a 2-week course of bismuth subcitrate, amoxicillin, and metronidazole. Group B patients were given placebo for iron and a 2-week course of triple therapy. Group C patients were given oral ferrous sulfate and a 2-week course of placebo. Iron status was reassessed 4 weeks and 8 weeks after the 2-week regimen ended. Of the 43 subjects with iron-deficiency anemia, 25 (58.1%) had H. pylori in the antrum. Group A and B subjects, who received eradication therapy, showed a significant increase in hemoglobin level as compared with group C subjects at 8 weeks after therapy (p = .0086). Treatment of H. pylori infection was associated with more rapid response to oral iron therapy as compared with the use of iron therapy alone. Such treatment also led to enhanced iron absorption even in those subjects who did not receive oral iron therapy.
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            Helicobacter pylori infection as a cause of iron deficiency anaemia of unknown origin.

            To assess the aetiological role of Helicobacter pylori (H. pylori) infection in adult patients with iron-refractory or iron-dependent anaemia of previously unknown origin. Consecutive patients with chronic iron-deficient anaemia (IDA) with H. pylori infection and a negative standard work-up were prospectively evaluated. All of them had either iron refractoriness or iron dependency. Response to H. pylori eradication was assessed at 6 and 12 mo from follow-up. H. pylori infection was considered to be the cause of the anaemia when a complete anaemia resolution without iron supplements was observed after eradication. H. pylori was eradicated in 88 of the 89 patients. In the non-eradicated patient the four eradicating regimens failed. There were violations of protocol in 4 patients, for whom it was not possible to ascertain the cause of the anaemia. Thus, 84 H. pylori eradicated patients (10 men; 74 women) were available to assess the effect of eradication on IDA. H. pylori infection was considered to be the aetiology of IDA in 32 patients (38.1%; 95%CI: 28.4%-48.8%). This was more frequent in men/postmenopausal women than in premenopausal women (75% vs 23.3%; P < 0.0001) with an OR of 9.8 (95%CI: 3.3-29.6). In these patients, anaemia resolution occurred in the first follow-up visit at 6 mo, and no anaemia or iron deficiency relapse was observed after a mean follow-up of 21 ± 2 mo. Gastric H. pylori infection is a frequent cause of iron-refractory or iron-dependent anaemia of previously unknown origin in adult patients.
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              Non-invasive techniques for the diagnosis of Helicobacter pylori infection.

              Helicobacter pylori infection can be diagnosed by invasive techniques requiring endoscopy and biopsy (histologic examination, culture, polymerase chain reaction), and non-invasive techniques (serology, urea breath test, urine or blood, detection of H. pylori antigen in stool specimen). However, recent studies have demonstrated that a strategy of 'testing and treating' for H. pylori in uninvestigated, young (<50 years), dyspeptic patients in primary care is safe and reduces the need for endoscopy. Indeed, a number of clinical guidelines recommend non-invasive testing in dyspeptic patients followed by treatment of H. pylori in primary care based on clinical and economic analyses. Several non-invasive tests are currently available on the market. The choice depends on the clinical circumstances, the likelihood ratio of positive and negative tests, the cost-effectiveness of the testing strategy, and, finally, the availability of the tests. Nevertheless, two non-invasive tests are commonly used: the urea breath test, and the stool antigen test.
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                Author and article information

                Journal
                rccm
                Revista Científica Ciencia Médica
                Rev Cient Cienc Méd
                Facultad de Medicina, Universidad Mayor de San Simón. (Cochabamba, Cochabamba, Bolivia )
                2077-3323
                2017
                : 20
                : 2
                : 21-25
                Affiliations
                [02] Lima orgnameHospital II Perú
                [01] Lima orgnameUniversidad Peruana Unión orgdiv1Sociedad Científica de Estudiantes de Medicina Perú vastidiaz@ 123456upeu.edu.pe
                Article
                S1817-74332017000200004 S1817-7433(17)02000200004
                b92a324b-67ef-4f78-97bf-05f491a73f42

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 15 December 2017
                : 01 April 2017
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 25, Pages: 5
                Product

                SciELO Bolivia

                Categories
                ARTÍCULOS ORIGINALES

                odds ratio,anemia,Helicobacter pylori
                odds ratio, anemia, Helicobacter pylori

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