胃癌高中低发区自然人群Hp感染的血清流行病学调查

目的调查幽门螺杆菌感染(Hp)与胃癌间的关系.方法于1992年12月—1993年2月在胃癌高、低、中发区以家庭为单位进行 Hp 感染的血清流行病学调查,以探讨在胃癌死亡率不同的地区间自然人群中 Hp 感染情况.血清检测采用间接 ELISA 法,该方法诊断 Hp 感染的特异性为86.8%,敏感性为93.9%.结果在胃癌高、中、低以区 Hp 阳性率分别为59.4%,55.9%,34.5%,三地区间差异非常显著(x~2=25.029,P=0.034).40岁以下各年龄组均以高发区感染率为高,且有随胃癌死亡率的升高 Hp 感染率亦升高的趋势,5岁以下组高发区已达50%,40岁及以上组各地区间 Hp 感染率接近.平均抗体水平在胃癌高、中、低发区分别为2.30±0.49,2.04±0.47,1.84±0.46,亦以高发区为高,与其他两地区比较差异非常显著(P<0.01).结合填表方式对所调查的变量进行多元回归分析,筛选出与感染可能有关的因素为经常饮生水、月人均收入低、经常服抗生素及三餐不按时,好生闷气等.单因素分析还表明 Hp 感染还与动物饲养于房内有关.结论 Hp 感染与胃癌发生成正相关.     

胃癌组织中幽门螺杆菌cagA和vacA的表达及与其感染的相关性

目的:研究HpyloricagA和HpylorivacA在胃癌、胃黏膜不典型增生和胃炎组织中的表达及与Hpylori感染的相关性.方法:采用Warthin-Starry嗜银染色法检测胃癌组织39例,胃黏膜不典型增生组织24例和慢性胃炎组织33例中Hpylori感染情况;PCR法检测上述标本中HpyloricagA和HpylorivacA的表达.结果:胃癌组织中Hpylori,HpyloricagA 株和HpylorivacA 株感染率显著高于慢性胃炎组织(χ2=7.00,P<0.05;χ2=15.20,P<0.05;χ2=12.43,P<0.05);胃黏膜不典型增生组织中Hpylori,HpyloricagA 株和HpylorivacA 株感染率显著高于慢性胃炎组织(χ2=6.25,P<0.05;χ2=11.04,P<0.05;χ2=11.61,P<0.05);低分化胃癌组织中Hpylori,HpyloricagA 和HpylorivacA 株感染率显著高于高中分化胃癌组织(χ2=8.19,P<0.05;χ2=13.14,P<0.05;χ2=6.62,P<0.05).慢性胃炎、不典型增生和胃癌组织中Hpylori与HpyloricagA和HpylorivacA表达均呈正相关(慢性胃炎:r=0.56,P<0.01;r=0.64,P<0.01;不典型增生组织:r=0.64,P<0.01;r=0.92,P<0.01;胃癌:r=0.90,P<0.01;r=0.95,P<0.01).结论:Hpylori感染是慢性胃炎向胃黏膜不典型增生及胃癌发展的重要启动因子,Hpylori感染可能通过诱导cagA表达促使胃黏膜上皮细胞增殖加快,诱导vacA表达促使胃黏膜上皮细胞损伤;他们的协同作用可能在胃癌发生、发展过程中发挥了重要作用.     

幽门螺杆菌细胞毒素相关蛋A与胃癌关系的病例对照研究

目的探讨幽门螺杆菌(Hp)细胞毒素相关蛋白A(CagA)阳性Hp感染与胃癌发病的关系.方法采用病例对照研究的方法,选择可能与胃癌发生有关的危险因素制定统一的调查表,胃癌组与对照组进行配比,配比比例为12.患者末梢血中Hp-CagA抗体的检测采用斑点金免疫渗滤法.胃癌的危险因素分析采用单因素及多因素Logistic回归分析、双因素分层分析.结果(1)不同年龄段的胃癌患者CagA阳性Hp感染率差异较大,年龄越小感染率越高,小于50岁胃癌患者100%感染CagA阳性Hp,随着年龄增长,感染率下降,呈显著的负相关(P＜0.01).(2)CagA阳性Hp感染率在高、中、低分化腺癌中分别为8.5%,8.5%,3.0%,彼此间相比,差异有显著性(P＜0.05),agA阳性Hp感染与低分化腺癌关系最密切.(3)胃癌组与对照1组及对照2组的11配比的单因素Logistic回归分析中,食酸辣食物、吸烟、进食不规律、精神因素、身体状况较差、饮酒、Ⅰ级亲属共患病及CagA阳性Hp感染等因素与胃癌的发生呈正相关,其中以CagA阳性Hp感染的OR最大,关系最为密切.进食新鲜蔬菜、水果与胃癌发病呈负相关,为胃癌的保护性因素.(4)多因素Logistic回归分析中,agA阳性Hp感染、吸烟、饮酒、进食不规律、精神因素等因素与胃癌的发生呈明显的正相关,其中以CagA阳性Hp感染的OR最大,关系最为密切.(5)双因素分层分析中,吸烟、饮酒、进食不规律、精神因素等因素与CagA阳性Hp感染之间并无交互作用.结论CagA阳性Hp感染与胃癌关系密切,重视CagA阳性Hp菌株的研究,对切断胃癌发生的早期环节、预防和治疗胃癌具有重要的临床和社会意义.     

COX-2基因多态性及H pylori感染与胃癌高发区甘肃河西地区胃癌的相关性

目的:研究COX-2-899G>C,COX-2codon 587G>A基因多态性在胃癌高发区甘肃河西地区健康人群与胃癌患者的分布,检测幽门螺旋杆(Hpylori)在上述人群中的感染情况,探讨COX-2-899G>C,COX-2codon587G>A基因多态性以及H pylori感染与河西地区胃癌发生的关系.方法:采用PCR-TaqMan探针法检测甘肃河西地区健康人群和胃癌患者COX-2-899G>C,COX-2codon 587G>A的基因多态性,用Warhin-starry染色法检测本研究对象的Hpylori感染率.结果:COX-2-899G>C分为G/G,G/C,C/C三种基因型,其频率在胃癌患者中分别为72.9％,21.4％,5.7％;在普通人群中分别为84.0％,12.8％,3.2％.与G/G基因型相比,COX-2-899*C基因携带者患胃癌的风险增加(OR=1.956,95％CI:1.067-3.586).COX-2codon587G>A三种基因型为G/G,G/A,A/A,其频率在胃癌患者中分别为86.4％,11.4％,2.2％;在健康人群中分别为89.6％,9.6％,0.8％.COX-2eodon 587G>A三种基因型在胃癌组和健康对照组间无显著性差别.Hpylori感染率在胃癌组和对照组分别为68.6％,50.4％,两组间具有显著差异(P=0.003).分层分析提示COX-2-899*C基因携带者若同时伴有Hpylori感染,其患胃癌的风险明显增加(OR=2.471,95％CI:1.076-5.675).结论:COX-2-899G>C的C等位基因增加我国胃癌高发区甘肃河西地区胃癌发病的风险,而且与H pylori感染对胃癌的发病有一定的协同作用;Cox-2 codon 587G>A基因多态性与甘肃河西地区胃癌的易感性无关.     

P53Arg72Pro多态性及H pylori感染与胃癌高发区甘肃河西地区胃癌的关系

目的:检测H pylori在甘肃河西地区健康人群与胃癌患者中的感染,并探讨P53Arg72Pro基因多态性以及H pylori感染与胃癌高发区甘肃河西地区胃癌发生的关系.方法:采用PCR-TaqMan探针法检测甘肃河西地区健康人群和胃癌患者P53Arg72Pro的基因多态性,用Warhin-starry染色法检测本研究对象的H pylori感染率.结果:H pylori感染率在胃癌组和对照组分别为68.6%,50.4%,H pylori感染率在两组间具有显著差异(OR=2.147,95%CI:1.302-3.541);P53Arg72Pro分为Arg/Arg,Arg/Pro,Pro/Pro3 种基因型,其频率在胃癌患者中分别为15.7%,60.0%,24.3%;在健康人群中分别为25.6%,54.4%,20.0%.与Arg/Arg基因型相比,Arg/Pro或Pro/Pro单独频率在2组间差异无统计学意义,但P53Pro等位基因(Arg/Pro+Pro/Pro)携带者在胃癌者和对照组间差异有统计学意义(OR=1.846;95%CI:1.006-3.387).分层分析提示H pylori阳性感染者或吸烟人群,若其同时携带有P53Pro等位基因,他们患胃癌的风险明显增加.结论:P53Arg72Pro位点基因多态性与我国胃癌高发区甘肃河西地区胃癌发病的风险相关,P53Pro等位基因与H pylori感染或吸烟因素有一定的协同作用.     

CagA~+幽门螺杆菌胃癌前及癌变中NF-κB的表达增强

目的:探讨核因子-κB(nuclearfactor-KappaB,NF-κB)在癌前病变及胃癌组织中的表达及其与细胞毒素相关抗原A幽门螺杆菌(CagA+Hpylori)感染之间的关系.方法:慢性浅表性胃炎34例,肠腺化生31例,不典型增生34例,胃癌55例,应用免疫组化方法(SABC法)检测NF-κBp65的表达,以14C-呼气试验、快速尿素酶试验和Warthin-Starry银染色检测Hpylori,采用斑点金免疫渗滤法检测患者血清抗HpyloriCagAIgG抗体,分析NF-κBp65表达与CagA+Hpylori感染之间、以及与胃癌组织学分型、临床病理分期、淋巴结转移的关系.结果:在慢性浅表性胃炎、肠腺化生、不典型增生和胃癌组中,NF-κBp65阳性表达率分别为15.0%,41.9%,64.7%和78.2%,呈逐渐增高趋势,各组间有显著性差异(χ2=43.98,P<0.01);Hpylori感染率分别为70.0%,67.7%,73.5%和54.5%,各组间无显著性差异(P>0.05).CagA+Hpylori构成比分别为53.6%,61.9%,68.0%和73.3%,各组间无显著性差异(P>0.05).在肠化组中,Hpylori阳性和CagA+Hpylori感染的患者NF-κBp65阳性表达率分别为57.1%和76.9%,显著高于同组无Hpylori感染的10.0%(χ2=6.18,P<0.05)和CagA-Hpylori感染者的25.0%(χ2=5.45,P<0.05).在胃癌组中,NF-κBp65阳性表达与T分期(χ2=5.91,P<0.05)及淋巴结转移有关(χ2=7.47,P<0.05),但与胃癌组织学分型无关(P>0.05).结论:NF-κB的异常活化在胃癌前病变及癌变过程中起作用,早期的活化与CagA+Hpylori感染有关.     

山东和北京地区幽门螺杆菌感染的流行病学研究

目的 探讨中国胃癌高发区山东牟平和低发区北京延庆儿童及成人幽门螺杆菌(H.pylori,Hp)感染现状及变化.方法 2006年5-7月检测两地区8～15岁儿童和40～79岁成人2065例.收集同地区90年代初资料及1991年和2006年于我院进行胃镜检查的所有病例11 656例,分析Hp感染率变化.结果 牟平儿童和成人Hp阳性率分别为37.69%和50.95%,显著高于延庆儿童和成人的25.58%和41.35%(P<0.01).与1991年相比,2006年牟平儿童Hp阳性率下降显著(P<0.001),而延庆儿章下降无统计学意义(P>0.05).两地区成人HP阳性率均显著下降(P<0.01).我院病例Hp感染率下降显著(P<0.001).结论 胃癌高发区儿童和成人Hp感染率显著高于胃癌低发区,Hp感染可能是胃癌发生的危险因素之一.近十多年来Hp感染率在中国人群中有下降趋势.     

胃黏膜细胞hMSH2,hMLH1和p53基因表达与幽门螺杆菌感染的关系

目的:探讨幽门螺杆菌(Hpylori)感染与胃癌、癌旁及胃炎黏膜中hMSH2,hMLH1和p53基因表达的关系. 方法:高中分化腺癌22例,低分化腺癌37例,黏液癌17例,浅表陛胃炎38例,正常对照10例,用快速尿素酶方法检测Hpylori感染,用免疫组化SP法检测hMSH2, hMLH1和p53基因的表达. 结果:(1)hMSH2在胃癌中的表达阳性率显著高于癌旁组织、胃炎黏膜和正常对照(67.1% vs 35.5%,42.1%,30.0%; P<0.01),其中,在低分化腺癌中阳性率显著高于高中分化腺癌和黏液癌(81.1% vs 54.5%,52.9%;P<0.05); hMLH1在胃癌中的表达阳性率低于非癌组织,但无显著性差异,其中,在黏液癌的阳性率显著低于其他两种腺癌(47.1% vs 81.8%,97.2%;P<0.001);p53在胃癌中的表达阳性率显著高于癌旁组织、胃炎黏膜和正常对照(47.4% vs 7.9%.0.0%,0.0%;P<0.001),其中,在黏液癌和低分化腺癌中的阳性率显著高于高中分化腺癌(64.7%,54.1% vs 22.7%;P<0.05). (2)在全部被检组织中,Hpylori感染组hMSH2和hMLH1 的表达阳性率均低于相应的非感染组,其中,胃癌Hpylori 感染组hMSH2的表达阳性率显著低于非感染组(56.8% vs 81.3%)(P<0.05).胃癌及癌旁组织Hpylori感染组p53的表达阳性率均高于非感染组,但无显著性差异. 结论:胃癌的发生发展可能与hMSH2和p53基因的高表达有关;Hpylori感染影响hMSH2,hMLH1和p53基因的正常表达,这可能是Hpylori致癌的机制之一.     

永康地区60岁以上人群钩虫病感染特点分析

目的 调查永康地区60岁以上人群钩虫病感染情况，分析感染特点，为永康地区钩虫病防治策略的制定提供科学依据。方法 2019年1月至2022年12月，随机抽检调查永康地区60岁以上人群21 147人，采用改良加藤厚涂片法(一粪两检)检测钩虫感染情况，收集感染率、感染度指标以及各镇、街道感染率。以调查问卷的形式收集研究对象的性别、年龄、受教育程度、职业、洗手习惯、家庭厕所情况、院内及周边植物种植情况，采用多因素非条件Logistic回归分析总结钩虫感染的影响因素。结果 本研究入组21 147人，确诊为钩虫病者51例，感染率为0.24%,各镇、街道感染率比较，差异无统计学意义(P>0.05),经非条件Logistic回归模型，引入各自变量单因素分析，钩虫感染的影响因素有性别、年龄、家庭厕所、受教育程度、职业、饭前、便后洗手(P<0.05),不包含院内及周边种植植物(P>0.05),经多因素分析，结果显示，性别、年龄、受教育程度是永康地区60岁以上人群钩虫感染的独立影响因素。结论 永康地区60岁以上人群钩虫感染率相对较低，且以轻度感染多见，根据相关影响因素制定措施进一步防治，可...     

中国自然人群幽门螺杆菌感染的流行病学调查

背景幽门螺杆菌(Hp)感染与多种上消化道疾病包括胃癌有关,而我国Hp感染状况尚无大宗调查报告。目的通过调查了解我国各地区Hp的部分流行病学特征为防治提供参考。方法中国幽门螺杆菌科研协作组从2002年1月～2004年6月对全国19个省、市、自治区一般人群26341人Hp感染的危险因素、地理差异与Hp感染率等进行调查。结果 Hp的总感染率为56.22%,广东地区Hp感染率最低为42.01%,西藏Hp的感染率最高为84.62%。成人各年龄组、性别间无显著性差异。Hp感染的危险因素可能与水源、职业、环境、生活条件、教育水平有关。吸烟、饮酒与Hp感染的关系需进一步研究。结论本研究数据显示我国一般人群Hp感染率相对较高,间接粪-口传播和生活条件是Hp感染的重要危险因素,初步结果显示多数在儿童期即被Hp感染。     

华北油田职工幽门螺杆菌流行病学调查

目的了解华北油田部分单位职工中幽门螺杆菌(Hp)感染率,探讨影响Hp感染的因素。方法采用14C-尿素呼气试验检测1233名职工,并对每人进行问卷调查,对其平时有无上消化道症状、卫生习惯及家族史等情况进行了解。结果本地区职工平均Hp感染率为60.67%,Hp感染率高低与是否饮酒、吸烟、结婚、教育程度间差异均无统计学意义(P>0.05),而在个人卫生习惯较差、有上消化道症状、胃病家族史者Hp感染率较高(P<0.05)。结论良好的个人卫生习惯、积极改善公共饮食卫生是降低幽门螺杆菌(Hp)感染率的有效方式。     

The prevalence of Helicobacter pylori infection in patients with gastrointestinal symptoms in Chon Buri, Thailand

The prevalence of Helicobacter pylori infection varies between different geographic locations. The objectives of this study were to determine the prevalence of H. pylori infection in patients with gastrointestinal (GI) symptoms and to describe the association of H. pylori infection with demographic data, clinical diagnosis, and previous histories of patients. The study was carried out at the gastroenterology unit of Queen Sawang Wattana Memorial Hospital, Chon Buri, Thailand. The diagnosis of H. pylori infection was done by culture and rapid urease test on the gastric biopsy specimens of 112 patients. The overall prevalence of H. pylori infection by the gastric biopsy-based method was 58%. The prevalence of H. pylori infection in duodenal ulcer (DU) patients (75%) was significantly higher than in gastric ulcer (GU) patients (56.4%) and patients with gastritis (44.1%). A reverse correlation was observed between H. pylori infection and household income. The prevalence of H. pylori infection in patients who usually consumed unboiled water was 61.6%, which was significantly higher than in those who consumed boiled water (30.8%). We conclude that the prevalence of H. pylori infection in patients with GI symptoms is relatively high, and H. pylori infection is associated with DU disease. The data suggests that the household income and not boiling drinking water are related to the high H. pylori infection in our study.     

Prevalence of Helicobacter pylori in a representative Anglo-Celtic population of urban Melbourne

The aims of this study were to assess the prevalence of Helicobacter pylori and its relationship with different epidemiological factors in an Anglo-Celtic Australian population in the Melbourne urban area. Two hundred and seventy-three (120 men and 153 women with a mean age of 55.6 and range of 20 to 80 years) of 396 eligible subjects randomly sampled from the telephone directory were studied. An ELISA technique was used to detect H. pylori immunoglobulin (Ig)G antibody and self-administered questionnaires were completed. The overall seroprevalence of H. pylori was 38% and increased with age from 18% (20–30 years old) to 53% (over 70 years; P < 0.0001). The acquisition of H. pylori infection was 1% per year. The prevalence of H. pylori was 48% in men and 30% in women ( P < 0.01). The frequency of H. pylori was also associated with low-income levels and current smoking, but was not associated with peptic ulcer disease history. The prevalence of H. pylori infection in a representative Australian population was found to be similar to other developed countries. The risk factors for H. pylori infection include age, male sex, low household income and a smoking habit. No correlation between H. pylori status and dyspepsia symptoms were observed.     

Helicobacter pylori infection in Kazakhstan: effect of water source and household hygiene

The epidemiology of Helicobacter pylori infection and risk factors associated with its transmission are not well understood. Kazakhstan is country with two ethnic groups, Asian (Kazakhs) and Western (Russians), living under similar socioeconomic conditions. The aim of this study was to examine the seroepidemiologic pattern of H. pylori and hepatitis A among the same individuals from both ethnic groups, with emphasis on water source and household sanitation practices. This was a cross-sectional seroepidemiologic study conducted among unrelated healthy individuals in Kazakhstan. From May through August 1999, individuals between the ages of 10 and 60 years from Almaty, Kazakhstan, were invited to participate. Demographic information, socioeconomic factors, living conditions, and various aspects of the local household environment including access to water were collected. A clean water index (CWI) was created based on combined factors, consistency of boiling water before drinking, frequency of storing and reusing water, and frequency of bathing and showering. H. pylori and hepatitis A antibodies were assessed by enzyme-linked immunosorbent assay. Two hundred eighty-eight individuals between the ages of 10 and 60 years participated. The prevalence of H. pylori infection was almost identical among the two ethnic groups (Russians 79% and Kazakhs 80%). H. pylori infection was inversely correlated with the CWI (i.e., 56%, 79%, and 95% for high, middle, and low, respectively (P < .05). Drinking river water had highest risk of H. pylori infection (OR = 13.6, 95% CI = 1.8-102.4; P < .01, compared with tap water). Crowding showed no significant effect on H. pylori prevalence. Anti-HAV antibodies were found in 86% of the population, 90% among the Russians versus 82% among the Kazakhs (OR = 1.8, 95% CI = 1.1-3.8, P = .05). Although the two infections were highly correlated (P < .001), antibody to both infections were present simultaneously in only 74%. The prevalence of H. pylori infection in Kazakhstan is very high. The data suggest that transmission of H. pylori can be water borne, related to poor sanitary practices, or both. The high prevalence of antibodies to H. pylori and HAV among this population is a marker for poor sanitation and hygienic practices. Reducing the rate of H. pylori transmission will require improvements in overall sanitation including clean water, waste disposal, as well as in household hygienic practices.     

天祝与兰州地区幽门螺杆菌感染流行病学对比研究

目的比较甘肃天祝县与兰州市两地区居民幽门螺杆菌感染状况,并考察各种相关因素对其感染率的影响。方法采用血清Helicobacterpylori IgG抗体金标渗滤斑点法和14 C 尿素呼气试验检测1780例2 0岁以上居民的H .pylori感染情况。结果天祝县H .pylori感染率76.8% ,显著高于兰州市的5 8.4% (P <0 .0 1)。汉藏两族及男女两性相比,其感染率均无显著差异(P >0 0 5 )。Hp感染与饮水源显著相关,饮用自来水者感染率显著低于饮用池塘/沟渠/河水和井水者(P <0 .0 1。H .pylori感染与人均年收入、碗筷洗刷情况、便后洗手和上消化道症状相关(P <0 .0 5 )。结论天祝和兰州两地区的H .pylori感染率均较高,且前者显著高于后者。H .pylori感染与饮用水源、生活卫生习惯、经济状况和上消化道症状等流行因素显著相关。     

Epidemiology and transmission route of Helicobacter pylori infection]

Helicobacter pylori (H. pylori) infection is a common bacterial infection among humans. Current knowledge implies that acquisition of H. pylori seems to occur predominantly in childhood and a major role of intrafamilial spread is now beyond controversy. However, the major route of transmission remains poorly understood. The prevalence of H. pylori infection continues to vary markedly between developing countries and developed countries, and according to ethnicity, place of birth and socioeconomic factors among people living in the same country. According to the nation-wide seroprevalence study for 5,732 asymptomatic Korean population, which was conducted from March 1998 to October 1998, the seroprevalence of H. pylori infection was 46.6%, showing the transition from a developing country to a developed country. The seroprevalence in children (neonate-15 yr) and adult (16-79 yrs) were 17.2% and 66.9%, respectively. According to multivariate analysis, variables such as sex, age, geographic area, crowding (number of person per room) in childhood, economic status in childhood, and types of housing in childhood were significantly and independently associated with H. pylori seroprevalence of adults. In children, age, geographic area, household income, mother's education, and drinking water source were significant factors of H. pylori infection. As 7 years has already passed since the nation-wide study, well designed study for the seroprevalence of H. pylori infection, by which epidemiological factors and the route of transmission of H. pylori infection could be discovered, is warranted.     

Prevalence of Helicobacter (formerly Campylobacter) pylori Infection in Saudia Arabia, and Comparison of Those with and without Upper Gastrointestinal Symptoms

A causative role is now accepted for Helicobacter (formerly Campylobacter) pylori in type B gastritis, and evidence is accumulating that H. pylori infection plays a major contributory role in duodenal ulcer, gastric ulcer, and epidemic gastric cancer. The prevalence of H. pylori in any population remains unknown. We compared the prevalence of H. pylori infection in the Riyadh region of Saudia Arabia, using a specific and sensitive ELISA for IgG antibody against the high molecular weight cell-associated antigen of H. pylori (urease). Subjects were interviewed, demographic data were collected, and a serum sample was obtained. Subjects completed a questionnaire that included questions about level of education, smoking, medications used, presence and frequency of symptoms referable to the upper gastrointestinal tract, and family history of ulcer disease. We studied 557 individuals (ranging in age from 5 to 91 yr). The prevalence of H. pylori infection increased rapidly with age: from 40% of those ages 5-10 yr, to more than 70% of those 20 or older. H. pylori infection occurred with significantly more frequency in adults with less than 12 yr of schooling, compared with adults who had attended college. The high rate of acquisition of H. pylori infection in Saudia Arabia emphasizes that studies of H. pylori-disease associations must consider the baseline prevalence of H. pylori infection in that population.     

Coffee and myocardial infarction: heterogeneity of an association in Portuguese men.

BACKGROUND: Despite the amount of published studies on the subject, controversy still exists about the effect of coffee drinking on the occurrence of coronary heart disease. In general, epidemiological studies do not support the belief that it is a major risk factor. DESIGN: A community-based case-control study was conducted. METHODS: A random sample of men aged 40 years and over with no previous myocardial infarction was compared with patients with a first acute myocardial infarction (AMI). A structured questionnaire was used to collect information on sociodemographic characteristics, personal and family medical history and lifestyles. Dietary data were obtained by a food frequency questionnaire. Odds ratios were calculated by unconditional logistic regression. After exclusions, 290 cases and 364 controls were considered in the final analysis. RESULTS: Coffee drinking is a widespread habit in this population, and most individuals did not change their habit throughout life. Most participants reported the consumption of moderate amounts of coffee (< 25% drank more than four cups a day) and espresso was by far the most commonly used brewing. The crude odds ratio for having ever drunk coffee regularly was 0.5 (95% confidence interval 0.3-1.1). However, there was a significant effect-measure modification by family history of AMI (P = 0.02). CONCLUSIONS: The results suggest different susceptibility to coffee drinking, such that coffee drinking was positively although not significantly associated with an increased risk of AMI in men with a family history of AMI, whereas there was a significant inverse association with the occurrence of myocardial infarction among men with no family history of AMI.     

Prevalence of Helicobacter pylori infection in children from an urban community in north-east Brazil and risk factors for infection

OBJECTIVES: To investigate the prevalence of Helicobacter pylori infection in a randomly selected population of children from a low income community in Brazil and the risk factors for infection. DESIGN: A cross-sectional, randomised study of prevalence and risk factors. SUBJECTS: Children living in an urban community in north-east Brazil. METHODS: H. pylori infection was determined using the C-urea breath test. Risk factors were assessed using a structured interview schedule. RESULTS: The overall prevalence of H. pylori was 56% (197/353). The infection was most common for those aged 12-14 years. In this group 75.4% (49/65) (95% CI, 63.1-85) of all children were positive for H. pylori, while in children less than 2 years of age 35.1% (13/37) (95% CI, 20.2-52.5) were positive. The prevalence of H. pylori increased significantly with age (P < 0.0001). In the bivariate analysis, a significant difference was found in the prevalence of H. pylori infection and age, number of persons per room, the number of children per household, cup sharing, and type of drinking water (P < 0.05). However, after logistic regression modelling only age (odds ratio (OR) = 1.3; 95% confidence interval (CI), 1.07-1.65), and number of persons per room (OR = 2.58; 95% CI, 1.4-4.6) were risk factors for H. pylori infection. CONCLUSIONS: H. pylori is highly prevalent among children in a north-eastern Brazilian community characterised by poor living conditions, and this infection is largely acquired during early childhood. The infection increased with age, and domestic overcrowding. Further longitudinal studies must examine in depth the possible modes of transmission of the organism in young children.