Context Hydrogen sulphide (H2S) has been proved to be a neuromodulator and contributes to the maintenance of gastric mucosal integrity in damage caused by anti-inflammatory nonsteroidal drugs. Previously, we demonstrated that H2S synthesis is essential to gastric protection against ethanol. Objective To better understanding the role of H2S and the detailed localization of its production in both normal and injured stomach due to ethanol injection, we studied the expression of cystathionine-γ-lyase (CSE) and cystathionine-β-synthetase (CBS) isoforms in gastric mucosa of mice treated with saline or 50% ethanol. Methods Mice were treated by gavage with saline or 50% ethanol (0.5 mL/25 g). After 1 hour, mice were sacrificed, and gastric tissue was evaluated by histological and immunohistochemical analysis specific for CSE and CBS. Results We have demonstrated a non-specific expression of CBS in the normal gastric mucosa and expression of CSE occurring mainly in the parietal cells of the animals treated with ethanol. Conclusion Thus, we demonstrated that the expression of CBS appears to be constitutive and diffuse across the gastric epithelium, while the expression of CSE appears to be induced in parietal cells by damage agents such as ethanol.

A talidomida é uma droga com efeito anti-inflamatório, imunomodulador e antiangiogênico. Devido a isso, vêm sendo publicados diversos relatos de casos, descrevendo sua eficácia no tratamento de hemorragia digestiva secundária à angiodisplasias do trato gastrointestinal, à doença inflamatória intestinal e um caso de resposta clínica na hemorragia secundária à ectasia vascular de antro gástrico (GAVE). No presente trabalho, relatamos o caso de uma paciente de 52 anos, com cirrose hepática e ectasia vascular do antro gástrico, que apresentou seis episódios de hemorragia digestiva alta com necessidade de transfusão sanguínea, apesar da terapia endoscópica estabelecida. Iniciamos talidomida na dose de 100 mg/dia que em seguida foi reduzida para 50 mg/dia. A paciente evoluiu com melhora clínica significativa, não apresentando novos episódios de sangramento, nem necessidade de transfusões sanguíneas. Apesar da interrupção da terapêutica endoscópica, persistiu assintomática e a endoscopia de controle após 3 meses não visualizava mais sangramento ativo nas lesões do antro. Portanto, este trabalho tem como objetivo descrever que a talidomida se mostrou eficaz, em baixa dose, para o controle do sangramento secundário à GAVE nesta paciente.

ABSTRACT BACKGROUND: The diagnosis of eosinophilic esophagitis (EoE) is performed by the detection of 15 or more eosinophils per field in an esophageal biopsy sample, but the endoscopic findings alone are not validated for a diagnosis of the disease. OBJECTIVE: To evaluate the association between the endoscopic findings and histopathological diagnosis in patients with suspected EoE in endoscopy. METHODS: A retrospective study of 24 patients with suspicion of EoE during endoscopy was held. The information was collected from databases of Endoscopy and Pathology services of the Hospital Universitário Walter Cantídio, Universidade Federal do Ceará, from March 2012 to April 2018. The patients were divided into a group with positive biopsy (>15 Eosinophils/field, N=8) and a group with negative biopsy (<15 Eosinophils/field, N=16), and the endoscopic findings were compared between the two groups. RESULTS: From a total of 24 patients, 79.1% had longitudinal grooves, 20.8% white exudates, 33.3% mucosal pallor or loss of vascularity and 45.8% had more than one endoscopic finding. There was a significant difference (P<0.05) in the evaluation of the finding of mucosal pallor or decreased vasculature alone among the groups. The positive predictive value and negative predictive value of the presence of more than one endoscopic findings for the diagnosis of EoE was 54% and 84%, respectively. CONCLUSION: There was a low association between the presence of endoscopic findings and histopathological confirmation of the disease, which indicates that endoscopic findings alone are not reliable for the diagnosis of EoE.

Background – The diagnosis of eosinophilic esophagitis (EoE) is performed by the detection of 15 or more eosinophils per field in an esophageal biopsy sample, but the endoscopic findings alone are not validated for a diagnosis of the disease. Objective – To evaluate the association between the endoscopic findings and histopathological diagnosis in patients with suspected EoE in endoscopy. Methods – A retrospective study of 24 patients with suspicion of EoE during endoscopy was held. The information was collected from databases of Endoscopy and Pathology services of the Hospital Universitário Walter Cantídio, Universidade Federal do Ceará, from March 2012 to April 2018. The patients were divided into a group with positive biopsy (>15 Eosinophils/field, N=8) and a group with negative biopsy (<15 Eosinophils/field, N=16), and the endoscopic findings were compared between the two groups. Results – From a total of 24 patients, 79.1% had longitudinal grooves, 20.8% white exudates, 33.3% mucosal pallor or loss of vascularity and 45.8% had more than one endoscopic finding. There was a significant difference (P<0.05) in the evaluation of the finding of mucosal pallor or decreased vasculature alone among the groups. The positive predictive value and negative predictive value of the presence of more than one endoscopic findings for the diagnosis of EoE was 54% and 84%, respectively. Conclusion – There was a low association between the presence of endoscopic findings and histopathological confirmation of the disease, which indicates that endoscopic findings alone are not reliable for the diagnosis of EoE.

A inflamação é uma resposta vascular, celular e humoral, responsável pelo processo de defesa dos organismos vivos ante agentes agressores. Essa resposta fisiológica é resultante da ação coordenada entre o sistema imunológico e o tecido no qual ocorreu a lesão. Por incorporar vários mecanismos biológicos, como a formação de edema, fagocitose, angiogênese, fibroplasia, liberação de mediadores químicos, além de outros fatores, a inflamação passou a ser entendida como um processo, proveniente de uma soma de eventos, que, de acordo com o tempo de evolução e as características patológicas envolvidas, pode ser classificada em in - flamação aguda ou crônica (KUMAR, 2010)

ABSTRACT BACKGROUND - Gastric polyps are elevated mucosal lesions. Most of them are less than 1 cm and when larger than 2 cm, has a high malignancy probability. The histopathological types are mainly fundic gland polyps, hyperplastic polyps and adenomatous polyps. OBJECTIVE - To evaluate the agreement between three different pathologists in the histopathological diagnosis of 128 biopsied gastric polyps in Digestive Endoscopy Unit from Walter Cantídeo University Hospital, between May 2010 to May 2012. METHODS - To describe the intensity of agreement between observers, we use kappa index that is based on the number of concordant measures between them. RESULTS - There was substantial agreement in the diagnosis of adenoma (kappa=0.799, CI: 0.899-0.698) and fundic glands (kappa=0.655, CI: 0.755-0.555). Regarding to hyperplastic polyps (kappa=0.415, CI: 0.515-0.315) and inflammatory (kappa=0.401, CI: 0.501-0.301), we obtained a moderate agreement. Regarding the presence of Helicobacter pylori in biopsy of the polyp, there was a low agreement (kappa=0.219, CI: 0.319-0.119). CONCLUSION - It is clear that the agreement between pathologists depends on the histological type of the biopsied polyp and this agreement is more substantial in adenoma, or fundic gland polyps.