Helicobacter-like Organisms Research Articles

MORTALITY AND MORBIDITY REVIEW IN THE UNITED KINGDOM EX SITU POPULATION OF EUROPEAN WILDCATS (FELIS SILVESTRIS) BETWEEN 2000 AND 2021.

The Scottish population of the European wildcat (Felis silvestris), the only remaining native felid species in the United Kingdom, is critically endangered and was declared functionally extinct by the International Union for Conservation of Nature in 2019. This retrospective study investigated the causes of morbidity and mortality reported in the United Kingdom captive wildcat population from 01 January 2000 to 31 December 2021. The aim was to assess the health and welfare of ex situ wildcats and, by making recommendations for management based on study findings, contribute to the sustainability of the population under managed care. Younger wildcats accounted for 85.7% of all morbidity cases (kittens, 7/77; young adults, 59/77), and the gastrointestinal (67.5% [52/77]), musculoskeletal (10.4% [8/77]), and integumentary (5.2% [4/77]) systems were most affected. Mortality was primarily associated with disease of the gastrointestinal (13.5% [12/89]), respiratory (13.5% [12/89]), neurological (5.6% [5/89]), and renal (5.6% [5/89]) systems. One quarter of all the histopathology examinations reported gastritis with associated Helicobacter-like organisms, often combined with pancreatitis or cholangiohepatitis. Neonates represented 25% (22/89) of all deaths, a high percentage compared with that of previous reviews in other nondomestic felids.

Detection of Helicobacter-like organisms in dogs with chronic gastric and intestinal inflammation

In humans, Helicobacter pylori and some other members of Helicobacteraceae are known to be implicated in both inflammatory and non-inflammatory gastrointestinal disorders. So far, conclusive evidence regarding the potential involvement of helicobacters in development of chronic inflammatory lesions of canine stomach and intestine is missing. The aim of the study was to determine the prevalence of Helicobacter-like organisms in endoscopic biopsy samples of different parts of the gastrointestinal tract of dogs with chronic inflammation and to reveal their potential relationship to the presence and severity of morphological and inflammatory changes. A total of 183 samples of inflammatory lesions were examined histologically and immunohistochemically. Helicobacter-like organisms were found in 64.1% of samples of gastritis, 5.3% of cases of duodenitis, 47.6% of cases of ileitis and 48% of cases of colitis. The most frequent gastric morphological change was surface epithelial injury. In duodenum epithelial injury together with villous stunting, and in ileum villous stunting were the most commonly observed morphological changes. Crypt dilation/ distortion was the most frequent morphological abnormality among colonic samples and was significantly more often a feature of colitis than duodenitis and ileitis. Our data show no effect of colonization with Helicobacter-like organisms on the presence of gastric pit epithelial injury and gastric mucosal fibrosis. No association was found between the presence/density of Helicobacter-like organisms and the presence or severity of morphological and inflammatory lesions of duodenal, ileal, and colonic mucosa.

Chronic Stress-Related Gastroenteric Pathology in Cheetah: Relation between Intrinsic and Extrinsic Factors.

Simple SummaryThe cheetah is the fastest land mammal. Habitat destruction, high mortality due to other predators, and illegal wildlife trade has led to a decrease in the wild population. Currently, the global adult population present in their natural habitat is estimated to be 7100 individuals. In captivity, the population suffers from limited reproduction and disease. Both the wild and captive populations have reduced genetic diversity from a historic bottleneck, leading to increased ecological and environmental vulnerability. Over the years, conservation programs have been developed for habitat protection, management of human–animal conflict, and the study of disease and genetics. Among these, the one with the greatest prevalence in captivity is chronic gastritis. This review analyzes the scientific literature on gastric pathology in cheetah, with the potential causes divided into “extrinsic factors”, such as living conditions and diet, and “intrinsic factors”, including the presence of Helicobacter-like organisms and the genetic predisposition.The rapid decline of cheetah (Acinonyx jubatus) throughout their range and long-term studies of captive breeding has increased conservation action for this species including the study of chronic diseases. Gastritis is one of the captive diseases that leads to high mortality presented with symptoms including vomiting, diarrhea, anorexia, and weight loss. The disease presents different histological lesions in the gastrointestinal tract that are characterized by inconstant and different clinical appearance in captive and free-range cheetahs. The aim of this review is to summarize the causes of chronic gastritis in the cheetah. Factors including diet, living conditions, infections with gastric Helicobacter-like organisms (GHLOs), the lack of genetic polymorphism and the cheetah’s specific-immunocompetence are analyzed. All studies on gastroenteric cheetah pathologies, conducted between 1991 (to the best of our knowledge, the first report on online databases) and 2021, are included in this review, highlighting the possible correlation between stress-related captive conditions and chronic gastric pathology.

Association of gastric lymphofollicular hyperplasia with Helicobacter-like organisms in dogs.

BackgroundThe relationships among gastric lymphoid follicular hyperplasia (GLFH), Helicobacter‐like organisms (HLOs), and clinical signs have not been established in dogs.ObjectivesTo evaluate the epidemiologic, clinical, endoscopic, and histopathologic findings associated with GLFH in dogs, and determine the association of GLFH with HLOs and the French Bulldog (FB) breed.AnimalsTwo hundred eighty‐eight dogs that underwent gastroscopy between 2013 and 2016.MethodsRetrospective, cross‐sectional study. Gastric biopsy samples were reviewed and scored for inflammation and HLOs. Dogs were divided into 3 groups: group 1 (63 FBs), group 2 (45 non‐FB brachycephalic dogs), and group 3 (180 nonbrachycephalic dogs). Variables were evaluated for their association with GLFH.ResultsUnivariate analysis determined that intact males, young age, vomiting, gastroscopic findings (discoloration, hemorrhage, and ulcers), and histopathologic findings (gastric lamina propria lymphocytic infiltration and HLO score) were associated with GLFH (P ≤ .03). In the multivariate analysis, GLFH was associated with the HLO score (odds ratio [OR] > 5 for HLO scores 1‐2 and >15 for HLO score of 3; P < .001), with vomiting (OR > 4; P = .01) but not with FB breed (P = .76) and age (P = .1). The HLO score was associated with younger age (P < .001).Conclusion and Clinical ImportanceThe HLO score was associated with a high GLFH score. Vomiting was associated with GLFH. Helicobacter‐like organisms are highly prevalent in young dogs and GLFH is indirectly associated with this factor. Clinical relevance of the identification of GLFH and HLO remains to be determined.

Epstein-Barr Virus associated gastric carcinoma in a patient with germline STAT3 gain-of-function mutation

Abstract Introduction/Objective Signal transducer and activator of transcription 3 (STAT3) is a transcription factor involved in inflammation, proliferation, differentiation and survival. STAT3 gain-of-function (GoF) disorders are characterized by immune dysregulation and present with polyendocrinopathy, enteropathy, X-linked syndrome (IPEX)- or autoimmune lymphoproliferative syndrome (ALPS)-like features. While patients with STAT-3 GoF are known to have an increased risk for hematologic malignancies, neither solid tumors nor an increased risk for EBV-associated disorders have been described. We report the first case of an EBV-associated solid organ tumor in a patient with STAT-3 GoF. Methods/Case Report A 21-year-old male with germline mutation in STAT3 (variant p. M329K) presented with early satiety, abdominal pain and worsening of chronic anemia. Serology showed high EBV DNA PCR levels. Endoscopy showed multiple nodular lesions in the stomach, which were biopsied to reveal EBV-associated high-grade dysplasia and intramucosal adenocarcinoma. Initiation of chemotherapy with a poor response led to a total gastrectomy. Gross examination of the specimen showed a 7.9 x 6.5 x 1.8 cm tan-brown, exophytic mass in the posterior wall of the body and antrum, involving the greater curvature. Histology revealed an adenocarcinoma with tubulovillous morphology extending into the lamina propria, without invasion into the muscularis mucosa or submucosa. EBER in-situ hybridization was diffusely positive in the tumor cells. The background mucosa showed severe chronic active and atrophic gastritis with intestinal metaplasia and low-grade dysplasia. All the seventy examined lymph nodes were negative for metastasis. Helicobacter-like organisms were not seen. Results (if a Case Study enter NA) NA Conclusion This is the first report of a solid tumor in a patient with STAT3 GoF mutation. The role of the patient’s underlying immune dysregulation disorder in the development of EBV-associated gastric adenocarcinoma is unclear and warrants further investigation. The case also highlights the importance of a close clinical follow-up in this patient population, as unexpected malignancies can develop at younger ages.

M\xe9n\xe9trier-like disease in a Pointer with concurrent granulomatous gastritis, helicobacteriosis and leishmaniosis: a case report

BackgroundMénétrier-like disease is a rare hypertrophic canine gastropathy, reported in only seven dogs. Clinical signs are vomiting, anorexia and weight loss. Macroscopically, giant cerebriform gastric mucosal folds are typically seen in the corpus and fundus of the stomach. Histopathologically, fundic mucous cell hyperplasia and loss of parietal and chief cells are typical.Case presentationA nine-year-old spayed female Pointer had a history of intermittent vomiting, marked weight loss and hypoalbuminaemia. A gastroduodenoscopy was performed three times within three months with macroscopic changes remaining the same. The gastric mucosa of the corpus, fundus and proximal antrum was markedly irregular, with cerebriform mucosal folds. In the first gastric biopsies, histopathology revealed a moderate granulomatous gastritis, with a severe manifestation of Helicobacter-like organisms. Treatment for Helicobacter spp. decreased the vomiting slightly. The dog was diagnosed with concurrent leishmaniosis; the conventional anti-Leishmania treatment decreased the vomiting moderately, the hypoalbuminaemia resolved and the dog gained weight back to a normal body condition. Granulomatous gastritis was not present in the gastric biopsies after these treatments. The dog increased vomiting when palliative treatment (maropitant citrate, ondansetron and esomeprazole) was discontinued, and thus, full-thickness biopsies of the stomach were taken and Ménétrier-like disease was diagnosed. The affected area was too large to be surgically removed; thus, palliative treatment was reinstated. The dog remained clinically well 39 months after the first clinical presentation.ConclusionsThis is the first report of Ménétrier-like disease in a dog with a simultaneous manifestation of granulomatous gastritis, helicobacteriosis and leishmaniosis. The clinical signs decreased after treatment of helicobacteriosis and leishmaniosis, but vomiting remained probably as a sign of Ménétrier-like disease. Treatment options for dogs are surgical removal of the abnormal area or palliative treatment. In humans, promising results for a cure have been shown with cetuximab treatment, a human monoclonal antibody, but no canine antibody is commercially available yet. The dog here was doing well 39 months after first presentation, which is the longest reported survival time for Ménétrier-like disease with only palliative treatment in dogs. Full-thickness biopsies are preferred in macroscopic hypertrophic lesions of the stomach for better assessment of Ménétrier-like disease.

Correlation between Different Helicobacter Morphotypes and Histological Changes in Pig Gastric Mucosa

Background: Two distinct morphologic types of bacteria which belong to the Helicobacter species, have been described in pigs: once or twice curved Helicobacter pylori-like bacteria (HLO) and the multicoiled, Gastrospirillum-like bacteria (GLO). The objective of this study was to determine the incidence of Helicobacter spp. using modified Giemsa stain and to define the relationship between presence of Helicobacter spp. and histopathological changes of gastric mucosa in pigs.Materials, Methods &amp; Results: A total of 120 pig stomachs (60 from intensive and 60 from extensive breeding) were enrolled in this study and 240 fragments of fundic and pyloric mucosa were taken for histopathological examination. By modified Giemsa staining of gastric mucosa, Helicobacter-like organisms were confirmed in 4/60 (6.67%) of pigs in intensive and 5/60 (8.33%) of pigs in extensive breeding. The incidence of tightly spiral shaped Gastrospirillum-like organisms in pigs of intensive and extensive breeding were 5/60 (8.33%) and 9/60 (15%), respectively. The severity of gastritis was scored to the Sydney System with some modifications. There was no significant difference between HLO-positive and HLO-negative fundic mucosa in pigs of both breeding systems. In contrary, there was significant difference between HLO-positive and HLO-negative pyloric mucosa of pigs in intensive (P &lt; 0.001) and in extensive breeding (P &lt; 0.05). In intensive breeding, there was significant difference between GLO-positive and GLO-negative fundic mucosa (P &lt; 0.05), while there was no significant difference between GLO-positive and GLO-negative pyloric mucosa.Discussion: The prevalence of Helicobacter spp. bacteria were in coherence with literature data. The higher prevalence of both morfological type of bacteria, were considered in pigs in extensive breeding. the hygienic conditions and managment factors in pigs farm are the possible impact for higher bacterial transmission. The association of high prevalence of H. pylori and poor hygienic condition was shown by epidemiological studies conducted on humans. In both, humans and pigs, the presence of H. pylori correlates with an inflammatory response, but there are differences in inflammatory cell population. In H. pylori infected humans, neutrophils composed the bulk of cellular infiltrate, while in pigs, the primary inflammatory cell was the lymphocyte, which is in accordance to results published by others autors. Thus it indicates that different hosts exhibit a different pathohistological response to the Helicobacter spp. infection. In human as well as in veterinary pathology, the fact of the different pathogenicity of various Helicobacter species is well known. In all HLO-positive pyloric mucosa, moderate to severe focal or diffuse infiltration of mononuclear cells and lymphoid follicles with germinal centers, were observed. A similar conclusion was drawn from results of an experimental infection study in pigs. There was signifficance between HLO-positive and HLO-negative pyloric mucosa in both, intensive and extensive breeding. In the contrast, GLO were not associated with the presence of severe gastritis, but only with mild to moderate superficial infiltration of lymphocytes and plasma cells in both, fundic and pyloric mucosa. There was no significant difference between GLO-positive and GLO-negative pyloric mucosa of pigs in both breeding systems. Despite the low gastritis score of fundic mucosa in pigs in intensive breeding, there was a significance difference between in GLO-positive and GLO-negative fundic mucosa. It is believed that the possible reason of such results is the meals with low fiber content and low particles size. These results suggest that the presence of HLO, but not of GLO is associated with the pyloric gastritis in pigs.

Analysis of the association between density of Helicobacter spp and gastric lesions in dogs.

OBJECTIVE To evaluate the correlation between the density of native gastric Helicobacter spp and the presence of gastric lesions in dogs. ANIMALS 80 dogs of various breeds, sexes, and ages. PROCEDURES Gastroscopic and histologic examinations were performed for all dogs. Helicobacter spp were detected by combining evaluation of urease activity and results of bacteriologic culture, microscopic observation, and a 16S rRNA PCR assay. The density of Helicobacter-like organisms was evaluated with light microscopy by use of Warthin-Starry modified stain. Correlations were evaluated by use of the Spearman correlation analysis. RESULTS Gastritis was found in 55 of 80 dogs and classified as mild (n = 31), moderate (16), or severe (8). Of these 55 dogs, only 8 had clinical signs. Histologic examination revealed some degree of lymphocytic-plasmacytic infiltrate, mild eosinophilia, and neutrophilic inflammation in the lamina propria. Seventy-six dogs had positive results for Helicobacter spp. Helicobacter pylori DNA was not detected. Low density and homogeneous distribution of Helicobacter spp were observed in all gastric zones. CONCLUSIONS AND CLINICAL RELEVANCE A significant correlation between density of Helicobacter spp and gastroscopic or histologic lesions was not detected. These findings supported the contention that there is no correlation between general Helicobacter spp density or numbers and gastritis in dogs.

Helicobacter spp. in domestic cats: identification and relationship with anatomical and histopathological gastric changes in animals of blood group A

ABSTRACT: The aim of this study was to evaluate the presence of gastric Helicobacter-like organisms and the endoscopic and histopathological changes in domestic cats with blood type A. Samples from the stomach antrum, body and fundus were collected from 32 mixed-breed stray domestic cats using gastroscopy. Urease testing and cytological analysis were performed in fresh samples. Tissue sections were processed and stained with hematoxylin and eosin (H&amp;E) and the Warthin-Starry (WS) silver staining methods for histopathological examination. Helicobacter spp. were detected in 100% of samples subjected to silver staining and cytological analysis, and in 96.9% of samples subjected to urease testing. In 87.5% of the cats, mononuclear inflammatory-cell infiltrates were identified. The graduation and distribution of inflammatory infiltrates in these cats revealed mild (78.1%) to moderate (9.4%) inflammatory changes in at least one gastric region. These changes were independent of the colonization score. Hyperplasia of the lymphoid follicles was detected in three cats. Cats of blood group A are often colonized by Helicobacter spp. and the macroscopic and microscopic findings are consistent with studies in domestic cats reported to date, concluding that the most common blood group in cats is not associated with high susceptibility to symptomatic gastritis.

Bacteremia and Skin Infections in Four Patients Caused by Helicobacter-Like Organisms.

Enterohepatic Helicobacter-like organisms (HLO) have been recognized as causes of human infection since 1984, primarily as a cause of bacteremia and cellulitis in immunocompromised individuals, but the spectrum of illness due to HLO has expanded based on numerous reports from Japan. We report 4 epidemiologically unrelated immunocompetent patients with HLO bacteremia diagnosed within a 2-year period. Three patients had cellulitis and 1 patient had unexplained fever. 16S ribosomal deoxyribonucleic acid (rDNA) sequence analysis of 2 isolates suggested that they were Helicobacter cinaedi, and whole-genome sequencing showed that they differed only slightly from reference strains. We believe that this syndrome is more common than reported, but it is easily overlooked because the skin lesions resemble streptococcal cellulitis and respond very rapidly to β-lactam antibiotics, and the organism is difficult to isolate from the blood. All HLO in our series were isolated from blood using the ESP system and were not detected in 2 other widely used commercial blood culture systems.

Nuclear Glycogen Inclusions in Canine Parietal Cells.

Nuclear glycogen inclusions occur infrequently in pathologic conditions but also in normal human and animal tissues. Their function or significance is unclear. To the best of the authors' knowledge, no reports of nuclear glycogen inclusions in canine parietal cells exist. After initial observations of nuclear inclusions/pseudoinclusions during routine histopathology, the authors retrospectively examined samples of gastric mucosa from dogs presenting with gastrointestinal signs for the presence of intranuclear inclusions/pseudoinclusions and determined their composition using histologic and electron-microscopic methods. In 24 of 108 cases (22%), the authors observed various numbers of intranuclear inclusions/pseudoinclusions within scattered parietal cells. Nuclei were characterized by marked karyomegaly and chromatin margination around a central optically empty or slightly eosinophilic area. The intranuclear inclusions/pseudoinclusions stained positive with periodic acid-Schiff (PAS) and were diastase sensitive, consistent with glycogen. Several PAS-positive/diastase-sensitive sections were further examined by transmission electron microscopy, also using periodic acid-thiocarbohydrazide-silver proteinate (PA-TCH-SP) staining to identify polysaccharides. Ultrastructurally, the nuclear inclusions were composed of electron-dense particles that were not membrane bound, without evidence of nuclear membrane invaginations or cytoplasmic organelles in the nuclei, and positive staining with PA-TCH-SP, confirming a glycogen composition. No cytoplasmic glycogen deposits were observed, suggesting that the intranuclear glycogen inclusions were probably synthesized in loco. Nuclear glycogen inclusions were not associated with gastritis or colonization by Helicobacter-like organisms ( P > .05). Our findings suggest that nuclear glycogen inclusions in canine parietal cells could be an incidental finding. Nevertheless, since nuclear glycogen is present in several pathologic conditions, further investigations could be warranted to determine their true significance.

The microbiological, histological, immunological and molecular determinants of Helicobacter pylori infection in guinea pigs as a convenient animal model to study pathogenicity of these bacteria and the infection dependent immune response of the host.

Helicobacter pylori is an etiological agent of chronic gastritis, gastric and duodenal ulcers and gastric cancers. The use of an appropriate animal model for experimental studies on the pathogenesis of H. pylori infections is necessary due to the chronic character of such infections and difficulties in identifying their early stage in humans. The aim of this study was to develop a guinea pig model of H. pylori infection and identify its microbiological, histological, serological and molecular determinants. Guinea pigs were inoculated per os with H. pylori strains: CCUG 17874 or ATCC 700312, both producing vacuolating cytotoxin A (VacA) and cytotoxin associated gene A (CagA) protein, suspended in Brucella broth with fetal calf serum (FCS) and Skirrow supplement of antibiotics. To determine H. pylori colonization, 7 and 28 days after the challenge, a panel of diagnostic methods was used. It included culturing of microorganisms from the gastric tissue, histopathological analysis of gastric sections, stained by Mayer,s haematoxylin and eosin to assess inflammatory response, by Giemsa as well as Warthin-Starry silver staining to visualise Helicobacter-like organisms (HLO) and with anti-Ki-67 antigen to assess epithelial cell proliferation. H. pylori infection was also confirmed by polymerase chain reactions (PCR) for detection in gastric tissue of ureC and cagA genes and by serological assessment of H. pylori antigens in faeces. This study showed the usefulness of microbiological, histological, immunological and molecular methods for the detection of persistent H. pylori infections in guinea pigs, which could be an appropriate model for studying H. pylori pathogenesis and the related immune response against these microbes.

A mixed population of Helicobacter pylori, Helicobacter bizzozeronii and "Helicobacter heilmannii" in the gastric mucosa of a domestic cat.

BackgroundThe presence of Helicobacter within the gastric mucosa is responsible for producing pathology in many animal species, including man. Since humans have been shown to harbour many of the same bacterial species as domestic carnivores, concern over their zoonotic potential has been growing. Helicobacter pylori, a class 1 carcinogen responsible for cases of gastritis and gastric cancer in humans, produces similar pathology in pet carnivores and is considered an example of anthroponosis. The case here presented refers to a 13 year-old mixed breed spayed female cat seen at necropsy.FindingsStomach samples were analysed for the presence of Helicobacter spp. by cytology, histopathology and PCR. Mild mucosal atrophy was observed in the fundus and antrum, while lymphoplasmocytic infiltrates where noted in the lamina propria of the antrum. Helicobacter-like organisms were observed in the corpus and antrum, occupying gastric glands and surface mucosa. It was possible to detect Helicobacter spp., H. pylori, H. heilmannii and H. bizzozeronii in the fundus, corpus and antrum by PCR, while in the antrum PCR samples were positive for H. pylori.ConclusionsThe spayed female under study could represent either a yet un-described population of domestic cats infected with H. pylori or a case of anthroponosis.

Evaluation of Gastric Lesions Based on Helicobacter pylori and Helicobacter-Like Organisms (HLOs) in Cats; A Histopathological and Bacteriological Study.

Background:The lesions induced by Helicobacter pylori in a candidate animal model should always be examined thoroughly. The resemblance of these lesions to those observed in humans can indicate whether the usage of this model will contribute to the understanding of the various pathogenic mechanisms involved in the development of human H. pylori-associated diseases.Objectives:The aim of this study was to perform a histopathological and bacteriological evaluation of gastric lesions based on H. pylori and Helicobacter-like organisms (HLOs) in cats.Materials and Methods:The present study was carried out on 28 cat’s (13 male and 15 female cases) gastric mucosae, which were tested by bacteriological and histopathological methods. Biochemical tests such as catalase, oxidase and urease were utilized in addition to Gram and Giemsa staining.Results:This research demonstrated that solely one case of H. pylori was isolated by gastric mucosal culture. Microscopically, the infected stomachs by HLOs comprised a mild to severe diffuse lymphoplasmacytic infiltration into the subglandular and gastric mucosa. Lymphoid follicles were also marked, particularly within pyloric tissues and mostly in displaced mucosal glands. For 75% of the gastritis cases, both HLOs and rapid urease tests were positive, whereas 83% of cases were more than one-year-old with gastritis. Furthermore, 75% of cats indicated gastritis, though 25% encompassed no gastritis; hence 20% had negative results for the rapid urease test and 25% for the Giemsa staining test. Such results may indicate that cats without gastritis were considered as free of HLOs pathogenic bacteria.Conclusions:These results suggest that most cases of gastritis were located in the antral region. Additionally, the isolation of H. pylori from domestic cats raises the possibility of zoonotic characteristics for the slightly pathogen; therefore transmission occurs from cats to human and vice versa.

Doğal Enfekte Köpeklerin Taze Mide İçeriği Örneklerinde Gastrik Helicobacter Türlerinin Taramalı Elektron Mikroskopi İle Değerlendirilmesi

Summary Different species of gastric Helicobacter-Like Organisms (GHLO) reported from dogs’ stomach. The aim of present study was to morphological evaluation of gastric Helicobacter spp. in fresh gastric samples of naturally infected dogs. Thirty two gastric samples of the stray dog were taken at necropsy. The specimens were used for rapid urease test, light microscopy, scanning electron microscopy (SEM) and polymerase chain reaction (PCR). Light microscopy examination confirmed the presence of GHLO in 90.5% of stray dogs. 87.5% and 94% of gastric samples were positive in rapid urease test and PCR, respectively. Four distinguishable Helicobacter organisms were confirmed by SEM. Three strains of these organisms were inditified as H. felis, candidatus H. heilmanii and H. bizzozeronii because of their apparent morphological differences and PCR results. The last strain of these bacteria was not distinguishable with routine studies. The large-scale studies with fast and simple recognition methods are recommended to confirm the different types of canine gastric Helicobacter. The results of present study showed further investigation in canine GHLO is required because new species of Helicobacter reported.

Eradication of gastric Helicobacter spp. by triple therapy in dogs

The aim of this study was to determine the efficacy of a triple anti-Helicobacter therapy using omeprazole, amoxicillin and clarithromycin (OAC) in dogs. A total of 15 healthy adult stray dogs with naturally acquired Helicobacter infection were evaluated using polymerase chain reaction and rapid urease test. Subsequently, they received a 21-day triple regimen. One day after the discontinuation of treatment, a second molecular analysis of gastric biopsies revealed complete eradication of Helicobacter DNA with negative quantitative urease testing in all 15 dogs. Our results confirmed the high prevalence of gastric Helicobacter-like organisms (GHLOs) in the stray dog population of Shiraz, Iran, and the effectiveness of our therapeutic regimen for the complete eradication of these microorganisms in stray dogs. In conclusion, for the complete elimination of non-pylori Helicobacter spp. from the gastric mucosa of dogs, a 21-day three-drug regimen with omeprazole, amoxicillin and clarithromycin is suggested.

Correlation between rapid urease test and pathohistological gastrobiopsy finding with positive immunological test in detecting Helicobacter pylori infection

Helicobacter pylori is a bacterium that has been in the limelight of gastroenterologists and oncologists worldwide since its immediate effect on the development of gastritis, ulcer disease, mucosa-associated lymphoid tissue lymphoma and gastric cancer was proved. The aim of this study was to determine the correlation between the positive immunological test, rapid urease test and pathohistological finding in detecting Helicobacter pylori infection of the gastric mucosa. This retrospective study included 250 endoscopic findings of subjects having undergone endoscopy in the first half of 2010 at the Ward of Gastroenterology, Department of Internal Diseases, Hospital in Senta. The endoscopy procedure was performed by Fujinon endoscopes and the fast urease test was done by the Cambridge Life Science set from England. The immunological test was carried out by the Vidas apparatus applying the Enzyme-Linked Fluorescent Assay (ELFA) technique and the staining for the pathohistological analysis was done by the modified Giemsa method. The paper presents the results obtained by endoscopic examination of a group of 250 patients performed at the Ward of Gastroenterology, Department of Internal Diseases, Hospital in Senta. The endoscopic findings were the first to be analyzed then the rapid urease test findings, which showed that 95 (38%) patients were positive and 155 (62%) patients were negative; whereas the immunologic test for Helicobacter pylori was positive in all 250 patients (100%). The histological test for Helicobacter-Like Organism was positive in 105 subjects (42%), whereas it was negative in 145 patients, that being 58% of all the cases. Sensitivity, specificity and predictability of the serological test and the rapid urease test were calculated according to the pathohistological finding as the "gold standard" and they were found to be: sensitivity 100% and specificity 0% for the serological test and sensitivity 90% and specificity 100% for the rapid urease test. The immunologic test was not correlated with other findings, and there was a high level of correlation between the rapid urease test and histological test (r = 0.927589261). The t-test was calculated to be 36.16513; p = 0.0001; that indicating that the correlation coefficient was statistically significant (p > 0.01). The obtained results were compared with the data found in the available literature sources. It can be concluded that the most competent technique for the optimal diagnosis of Helicobacter pylori infection is the invasive one with the pathohistological examination of bioptates together with the rapid urease test.

Assessment of antimicrobial resistance of cultivable Helicobacter-like organisms in asymptomatic dogs

Summary This study was performed to detect cultivable canine gastric Helicobacter-like organisms (GHLO's) and to evaluate their sensitivity to common antibiotics in two groups of naturally infected dogs (pets and stray dogs). Gastric samples were taken from the body and antrum of 30 pets and 30 stray dogs. From each part of canine gastric mucosa, four gastroscopic samples were used for impression smear, rapid urease test (RUT), polymerase chain reaction (PCR) and culture examination. 88.5% and 95% of gastric samples were positive for the presence of GHLO's in cytological and PCR examination, respectively. From 60 canine gastric cultures, successful growth happened in 17 cases. Antimicrobial sensitivity test was performed by disk method. All isolates of helicobacters were highly susceptible to polymyxin B, ampicillin, tetracycline, clarithromycin, erythromycin and gentamicin. Two isolated GHLO's were resistant to metronidazole. One strain also was resistant to amoxiclav, ceftriaxone, norfloxacin and oxytetracycline. This matter could show the resistance of some strains of helicobacters to different antimicrobials in veterinary medicine. With regards to the results of this study, it is recommended that antibiotic sensitivity test or use of concurrent different antibiotics be tried in the case of treatment resistance.

Pathology of gastritis and gastric ulceration in the horse. Part 1: Range of lesions present in 21 mature individuals

Gastric ulceration is now widely recognised as an important disease in high performance horses. Little is known about gastric histopathology in healthy or diseased animals; a comprehensive assessment would enhance interpretation of gross findings through assessment of their accuracy and allow for identification of lesion variety and pathogenesis in different anatomical regions of the stomach. To investigate the true extent and variety of gastric lesions in a mixed population of mature horses at post mortem. Stomachs were removed from a mixed population of 21 horses at post mortem. Mucosal abnormalities were recorded in photographic and written form. Representative samples from all gross lesions were taken for histopathology and processed routinely. Special stains including Gram, PAS and Warthin Starry, were used when appropriate. Pathological classification of lesion type using both gross and histological appearances was performed. Classification of lesions within the squamous region included hyperkeratosis, punctate scars, diffuse erosions/ ulcerations and margo injuria; and within the glandular region, hyperaemia, focal erosions and ulcerations. Glandular metaplasia was recognised for the first time in the equine stomach. No Helicobacter-like organisms were detected in association with lesion development. This study used gross and histological examination to highlight the large variety of naturally occurring gastric lesions in a mixed population of horses. Analysis of the pathogenesis of lesion development is now possible. Further research regarding the range of pathology in larger, more diverse groups of horses is required.

Which test, coronary angiography or colonoscopy?

A 87-year-old man was conducted to the Emergency Unit after a syncope. At admittance, the patient was awake, asymptomatic for chest pain, Troponin I values were 0.02 lg/L, Glasgow coma scale (GCS) score was 15, the blood pressure 110/ 55 mmHg, the pulse 90 beats per minute, the peripheral oxygen saturation 98%. Laboratory tests only showed microcytic hypochromic anemia [hemoglobin level 9.8 g/dL; hematocrit 31.1%; mean cell volume (MCV) 77.7 fL; mean cell hemoglobin (MCH) 24.3 pg; mean concentration of hemoglobin per volume of red cells (MCHC) 31.3 g/dL]. He reported assumption of sublingual nitrates some minutes before the syncope for chest pain caused by a mild effort (Valsalva). Six hours after admittance, the patient was still asymptomatic, his conditions appeared stable, Troponin I values remained within the normal range and he was transferred to our medical ward to complete the diagnostic and therapeutic work-up. Relevant past history included, 11 years before, demonstration of coronary artery disease (CAD) [75% stenosis of left circumflex and first obtuse marginal arteries, 50% stenosis of mid left anterior descending artery, and subcritical stenosis (\50%) of second obtuse marginal artery], treated with medical therapy. Few months after diagnosis of CAD, acetylsalicylic acid (ASA) was substituted by ticlopidine because of melena and heartburn; at that time an esophagogastroduodenoscopy (EGDS) showed no lesions. Thereafter the patient suffered from chronic angina with stable threshold (functional classification class II of the Canadian Cardiovascular Society) relieved by nitrates. Five years before the admission a microcytic hypochromic anemia was demonstrated, an EGDS was repeated and showed chronic atrophic gastritis with Helicobacter-like organism (HLO) ?, eradication therapy was started but discontinued for adverse effects. A contemporary gradual reduction of the anginal threshold was noted. Six months before the admission anorexia, with weight loss of about 7 kg, and constipation developed. Physical examination revealed: pale discoloration of skin, high-frequency low-grade systolic murmur audible on all cardiac auscultation areas, a non-tender non-pulsatile roundish mass deeply palpable in the right iliac fossa of several (6–8) centimetres of diameter, of increased consistency and preserved mobility on abdominal wall. Ultrasound examination of the abdomen was performed and revealed a kidney-shaped mass of 7 9 7 9 8 cm dimensions, suggesting a right colon cancer. Colonoscopy showed an ulcerated cauliflower-shaped lesion in the cecum occupying the whole intestinal lumen. The histological examination of a biopsy specimen confirmed the diagnosis of the adenocarcinoma of the colon. CT scan of the abdomen showed a large irregular thickening of the cecum wall with regional lymph nodes involvement without signs of distant metastases. I. Cecioni F. Fassio C. Alamanni F. Almerigogna Division of Immunology and Cellular Therapies, Department of Internal Medicine, University of Florence, Florence, Italy