Gastroenterology Insights

2024

Jump to: 2023, 2022, 2021

13 pages, 1100 KiB

Open AccessArticle

Resection of the Inferior Vena Cava Due to Tumor Involvement Allows Long-Term Survival in Different Neoplasms

by Isabel Jaén-Torrejimeno, Diego López-Guerra, Adela Rojas-Holguín, Antonio Enrique Gómez-Martin and Gerardo Blanco-Fernández

Gastroenterol. Insights 2024, 15(4), 865-877; https://doi.org/10.3390/gastroent15040060 - 26 Sep 2024

Viewed by 815

Abstract

Background: The involvement of the inferior vena cava in advanced abdominal tumors is a surgical challenge, given the high postoperative morbidity and poor long-term prognosis. Our goal was to analyze our experience, perioperative management, and results. Methods: We retrospectively evaluated short and long-term [...] Read more.

Background: The involvement of the inferior vena cava in advanced abdominal tumors is a surgical challenge, given the high postoperative morbidity and poor long-term prognosis. Our goal was to analyze our experience, perioperative management, and results. Methods: We retrospectively evaluated short and long-term results of surgical resections of tumors with associated inferior vena cava resection performed in our facilities between 2012 and 2023. Results: A total of 25 patients were selected for our retrospective study: 3 with renal carcinoma, 5 with sarcoma, 12 with metastatic lesions, 2 with adrenal tumors, 1 pancreatic tumor, 1 extra-adrenal paraganglioma and 1 with hepatocellular carcinoma. Postoperative severe complications (Dindo-Clavien score ≥ IIIa) affected 36% of patients and the mortality rate was 8%. Partial resection with primary repair was performed in 13 patients (52%), with patch reconstruction in 6 (24%), and vascular reconstruction with prosthesis in 6 patients (24%). The mean disease-free survival was 7 months (IQR 2.5–11.5). Graft thrombosis occurred in 2 patients during follow-up. Conclusions: In selected patients, the resection of the inferior vena cava is a complex surgery with an assumable morbimortality and relative survival improvement. Full article

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14 pages, 3227 KiB

Open AccessArticle

A Preliminary Study Examining the Correlation between EGFRI Treatment, Clinic Dermatoscopy Features, and Serum Levels of Anti-Alpha-Galactosyl IgE in Colorectal Cancer Patients

by Cristina Maria Popa, Irina Florina Cherciu Harbiyeli, Ana Maria Ciurea, Irina Mihaela Cazacu, Simona Laura Ianosi, Michael Schenker and Adrian Saftoiu

Gastroenterol. Insights 2024, 15(2), 505-518; https://doi.org/10.3390/gastroent15020037 - 17 Jun 2024

Viewed by 1286

Abstract

The introduction of molecularly targeted therapies, particularly the epidermal growth factor receptor inhibitors (EGFRIs), has had a positive impact by increasing the life expectancy of patients with advanced colorectal cancer (CRC). The most used anti-EGFRIs monoclonal antagonist, Cetuximab, induces skin responses in most [...] Read more.

The introduction of molecularly targeted therapies, particularly the epidermal growth factor receptor inhibitors (EGFRIs), has had a positive impact by increasing the life expectancy of patients with advanced colorectal cancer (CRC). The most used anti-EGFRIs monoclonal antagonist, Cetuximab, induces skin responses in most patients, leading to a reduction of dosages or even therapy discontinuation, all with devastating effects. Our study aimed to assess the predictive role and the possible correlations of clinical features, imaging aspects (dermatoscopy), and laboratory tests (anti-alpha-galactosyl IgE levels) for early detection of Cetuximab skin toxicity in patients with metastatic CRC. The association of IgE antibodies against goat alpha-1,3-galactose serum levels with various degrees of skin toxicity encountered during the oncologic treatment resulted in higher concentrations in patients with pruritus and hair changes. Incorporating dermatoscopy into the routine dermatological consultation allowed us to perform a severity assessment, dynamically record, and identify even the erupting lesions previously invisible to classical examination. Hence, we were enabled to generate a broad report and to classify various degrees of skin toxicity severity linked to Cetuximab treatment in 19 patients with metastatic CRC. Detecting the emergent lesions and initiating dermatological treatment in the early stages decreased the severity of skin toxicity. As a result, the duration of the antibiotic treatment was much shorter, and the risk of dose reduction or interruption of the cancer treatment was diminished. In conclusion, we emphasize the need for a regular dermatological examination with dermatoscopy of CRC patients undergoing Cetuximab treatment. Skin toxicity is a significant concern for these patients, and healthcare providers should be vigilant in monitoring and managing this side effect in order to optimize patient care. The correlation between anti-alpha-Gal IgE levels and Cetuximab-induced skin toxicities is an emerging area. More extensive studies need to be published in order to establish this relationship directly. Full article

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9 pages, 1237 KiB

Open AccessArticle

Identification of an Objective Cut-Off Point to Define the Clinical Stage T4a in Colon Cancer

by Carolina Bautista-Saiz, Luisa F. Rivera-Moncada, Leonardo S. Lino-Silva, Guillermo A. Pérez-Correa and Pedro Frías-Fernández

Gastroenterol. Insights 2024, 15(2), 366-374; https://doi.org/10.3390/gastroent15020025 - 30 Apr 2024

Viewed by 1038

Abstract

Introduction: The current state of pathology practice and the variability in diagnosing pT4a colon cancer have been underexplored in existing studies. Our objective was to establish a specific cutoff point to distinguish between the pathological stages of pT3 and pT4a in colon cancer. [...] Read more.

Introduction: The current state of pathology practice and the variability in diagnosing pT4a colon cancer have been underexplored in existing studies. Our objective was to establish a specific cutoff point to distinguish between the pathological stages of pT3 and pT4a in colon cancer. Methods: We conducted a cross-sectional study involving pT3 and pT4 (pN0-2, cM0) colon cancers, measuring the distance to the serosa. Patients were categorized and analyzed based on this distance and the peritoneal reaction, with the aim being to ascertain their prognostic implications. Results: A total of 384 patients were analyzed. Patients with a distance between the invading front of cancer and the serosa ≥ 1 mm without a peritoneal reaction exhibited a median survival of 118 months, contrasting the amount of 70 months for those with <1 mm plus peritoneal reaction. Only lengths <1 mm with peritoneal reaction showed a significant correlation with mortality (p < 0.001). Conclusion: Our study revealed that patients in whom neoplastic cells were less than 1 mm from the serosal surface, accompanied by a peritoneal reaction (hemorrhage, inflammation, neovascularization, fibrin), had significantly lower survival rates compared to those with more than 1 mm distance and without peritoneal response (70 vs. 118 months, p < 0.001). Hence, such cases should be considered within the pT4a stage. Full article

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2023

Jump to: 2024, 2022, 2021

11 pages, 1566 KiB

Open AccessArticle

Significance of Micromorphological Characteristics and Expression of Intermediate Filament Proteins CK7 and CK20 in the Differential Diagnosis of Serrated Lesions of the Colorectum

by Ivan Ilić, Pavle Ranđelović, Žaklina Mijović, Maja Jovičić Milentijević, Biljana Radovanović Dinić and Jana Cvetković

Gastroenterol. Insights 2023, 14(1), 110-120; https://doi.org/10.3390/gastroent14010008 - 26 Feb 2023

Viewed by 1966

Abstract

Serrated lesions in the colorectum include all epithelial neoplastic lesions, which show a sawtooth-like morphology in the epithelial crypts. Classification systems nosologically divide colon serrated polyps into three different categories, primarily emphasizing their micromorphological growth pattern and cytodifferentiation: (1) hyperplastic polyps, (2) sessile [...] Read more.

Serrated lesions in the colorectum include all epithelial neoplastic lesions, which show a sawtooth-like morphology in the epithelial crypts. Classification systems nosologically divide colon serrated polyps into three different categories, primarily emphasizing their micromorphological growth pattern and cytodifferentiation: (1) hyperplastic polyps, (2) sessile serrated adenomas/polyps and (3) traditional serrated adenomas. Overall, 109 patients with serrated lesions of the colon, who underwent endoscopic or surgical polypectomy/tumorectomy during one or multiple endoscopic or surgical interventions, over a four-year period, were analyzed. The average age of patients was 62.8 ± 11.6 years. The frequency of serrated lesions of the colon in male patients was 2.4 times higher than in females (70.6% vs. 29.4%). All sessile serrated lesions without dysplasia were positive for CK7 and statistically significant compared to other serrated lesions, if this positivity was present in the complete crypt (p = 0.005). CK20 positivity, which is limited to the upper half of the crypt, is a special feature of hyperplastic polyps compared to other serrated lesions, which is statistically significant (p = 0.0078). Whereas, CK20 positivity of complete crypts is a statistically significant feature of traditional serrated adenomas (p < 0.01). Differences in the expression pattern of cytokeratin 7 and 20 in different serrated lesions may indicate different pathways of colorectal carcinogenesis, and be diagnostically and prognostically useful. Full article

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46 pages, 5151 KiB

Open AccessArticle

Congenital Gastrointestinal Anomalies in Europe 2010–2019: A Geo-Spatiotemporal and Causal Inferential Study of Epidemiological Patterns in Relationship to Cannabis- and Substance Exposure

by Albert Stuart Reece and Gary Kenneth Hulse

Gastroenterol. Insights 2023, 14(1), 64-109; https://doi.org/10.3390/gastroent14010007 - 23 Feb 2023

Cited by 4 | Viewed by 2481

Abstract

Introduction: Congenital anomalies (CA’s) of most of the gastrointestinal tract have been linked causally with prenatal or community cannabis exposure. Therefore, we studied this relationship in Europe. Methods: CA data were from Eurocat. Drug-use data were sourced from the European Monitoring Centre for [...] Read more.

Introduction: Congenital anomalies (CA’s) of most of the gastrointestinal tract have been linked causally with prenatal or community cannabis exposure. Therefore, we studied this relationship in Europe. Methods: CA data were from Eurocat. Drug-use data were sourced from the European Monitoring Centre for Drugs and Drug Addiction. Income data were taken from the World Bank. Results: When countries with increasing rates of daily cannabis use were compared with those which were not, the overall rate of gastrointestinal CA’s (GCA’s) was higher in the former group (p = 0.0032). The five anomalies which were related to the metrics of cannabis exposure on bivariate analysis were bile duct atresia, Hirschsprungs, digestive disorders, annular pancreas and anorectal stenosis or atresia. The following sequence of GCA’s was significantly linked with cannabis metrics at inverse-probability-weighted-panel modelling, as indicated: esophageal stenosis or atresia, bile duct atresia, small intestinal stenosis or atresia, anorectal stenosis or atresia, Hirschsprungs disease: p = 1.83 × 10⁻⁵, 0.0046, 3.55 × 10⁻¹², 7.35 × 10⁻⁶ and 2.00 × 10⁻¹², respectively. When this GCA series was considered in geospatial modelling, the GCA’s were significantly cannabis-related from p = 0.0003, N.S., 0.0086, 6.652 × 10⁻⁵, 0.0002, 71.4% of 35 E-value estimates and 54.3% minimum E-values (mEVv’s) > 9 (high zone) and 100% and 97.1% > 1.25 (causality threshold). The order of cannabis sensitivity by median mEVv was Hirschsprungs > esophageal atresia > small intestinal atresia > anorectal atresia > bile duct atresia. Conclusions: Seven of eight GCA’s were related to cannabis exposure and fulfilled the quantitative criteria for epidemiologically causal relationships. Penetration of cannabinoids into the community should be carefully scrutinized and controlled to protect against exponential and multigenerational genotoxicity ensuing from multiple cannabinoids. Full article

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2022

Jump to: 2024, 2023, 2021

9 pages, 534 KiB

Open AccessArticle

Evaluation of Tumor Necrosis Factor-Alpha Gene (−308 G/A, −238 G/A and −857 C/T) Polymorphisms and the Risk of Gastric Cancer in Eastern Indian Population

by Kanishka Uthansingh, Girish Kumar Pati, Prasanta Kumar Parida, Jimmy Narayan, Subhasis Pradhan, Manoj Kumar Sahu and Rabindra Nath Padhy

Gastroenterol. Insights 2022, 13(4), 340-348; https://doi.org/10.3390/gastroent13040034 - 10 Oct 2022

Cited by 3 | Viewed by 2249

Abstract

Introduction: Gastric cancer (GC) is one of the leading causes of cancer-related decimations worldwide. The gastric infection at both the stomach and duodenum with Helicobacter pylori causes inflammation by the tumor necrosis factor-alpha (TNF-α). The aim of the study was to associate and [...] Read more.

Introduction: Gastric cancer (GC) is one of the leading causes of cancer-related decimations worldwide. The gastric infection at both the stomach and duodenum with Helicobacter pylori causes inflammation by the tumor necrosis factor-alpha (TNF-α). The aim of the study was to associate and evaluate the three TNF-α gene polymorphisms at positions −308 G/A, −238 G/A, and −857 C/T with the risk of GC. Methods: A total of 156 individuals (consecutively diagnosed 95 GC patients and 61 controls) above the age of 18 years were enrolled in the study. Healthy individuals with normal upper gastrointestinal endoscopy (UGIE) irrespective of their family history of GC or peptic ulcer were included as controls. The cited three TNF-α gene polymorphisms were evaluated using polymerase chain reaction-restriction fragment length polymorphism (RFLP). Results: There was no significant difference in the distribution of gene polymorphisms as genetic factors, TNF-α−308 GA/AA (22.1% vs. 14.8%, p = 0.2), TNF-α−238 GA/AA (21% vs. 19.6%, p = 0.8), and TNF-α−857 CT/TT (8.4% vs. 11.5%, p = 0.5), between GC cases and healthy controls. A subgroup analysis of H. pylori-positive patients showed that there was no significant difference in the distribution of GA/AA polymorphisms in TNF-α−308 (15(45.5%) vs. 3(23%); p = 0.17) and −238 (12(36.3%) vs. 2(15.4%); p = 0.17), and the distribution of TT/CT −857 CT/TT (13(39.4%) vs. 2(15.4%); p = 0.13), among the GC cases and controls. Conclusion: The statistical comparisons of GA/AA vs. GG genotypes at −308 (with OR = 1.6, 95% CI: 0.6–3.8), −238 (OR = 1.09, 95% CI: 0.4–2.4) and TT/CT vs. CC genotypes at −857 (OR = 0.7, 95% CI: 0.2–2.1) did not suggest any association of TNF-α with GC in the population herein. Hence, the TNF-α (−308 G/A, −238 G/A and −857 C/T) may not be the associating factor for GC incidence determined by the PCR–RFLP method. Full article

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11 pages, 1699 KiB

Open AccessArticle

UPolySeg: A U-Net-Based Polyp Segmentation Network Using Colonoscopy Images

by Subhashree Mohapatra, Girish Kumar Pati, Manohar Mishra and Tripti Swarnkar

Gastroenterol. Insights 2022, 13(3), 264-274; https://doi.org/10.3390/gastroent13030027 - 10 Aug 2022

Cited by 8 | Viewed by 2753

Abstract

Colonoscopy is a gold standard procedure for tracking the lower gastrointestinal region. A colorectal polyp is one such condition that is detected through colonoscopy. Even though technical advancements have improved the early detection of colorectal polyps, there is still a high percentage of [...] Read more.

Colonoscopy is a gold standard procedure for tracking the lower gastrointestinal region. A colorectal polyp is one such condition that is detected through colonoscopy. Even though technical advancements have improved the early detection of colorectal polyps, there is still a high percentage of misses due to various factors. Polyp segmentation can play a significant role in the detection of polyps at the early stage and can thus help reduce the severity of the disease. In this work, the authors implemented several image pre-processing techniques such as coherence transport and contrast limited adaptive histogram equalization (CLAHE) to handle different challenges in colonoscopy images. The processed image was then segmented into a polyp and normal pixel using a U-Net-based deep learning segmentation model named UPolySeg. The main framework of UPolySeg has an encoder–decoder section with feature concatenation in the same layer as the encoder–decoder along with the use of dilated convolution. The model was experimentally verified using the publicly available Kvasir-SEG dataset, which gives a global accuracy of 96.77%, a dice coefficient of 96.86%, an IoU of 87.91%, a recall of 95.57%, and a precision of 92.29%. The new framework for the polyp segmentation implementing UPolySeg improved the performance by 1.93% compared with prior work. Full article

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13 pages, 1238 KiB

Open AccessReview

The Outcomes of Nutritional Support Techniques in Patients with Gastrointestinal Cancers

by Vlad-Alexandru Ionescu, Gina Gheorghe, Ruxandra Oprita, Madalina Stan-Ilie, Raluca-Ioana Dascalu, Ondin Zaharia, Viorel Jinga, Camelia Cristina Diaconu and Gabriel Constantinescu

Gastroenterol. Insights 2022, 13(3), 245-257; https://doi.org/10.3390/gastroent13030025 - 5 Aug 2022

Cited by 2 | Viewed by 2937

Abstract

Gastrointestinal cancers represent a major cause of morbidity and mortality worldwide. A significant issue regarding the therapeutic management of these patients consists of metabolic disturbances and malnutrition. Nutritional deficiencies have a negative impact on both the death rates of these patients and the [...] Read more.

Gastrointestinal cancers represent a major cause of morbidity and mortality worldwide. A significant issue regarding the therapeutic management of these patients consists of metabolic disturbances and malnutrition. Nutritional deficiencies have a negative impact on both the death rates of these patients and the results of surgical or oncological treatments. Thus, current guidelines recommend the inclusion of a nutritional profile in the therapeutic management of patients with gastrointestinal cancers. The development of digestive endoscopy techniques has led to the possibility of ensuring the enteral nutrition of cancer patients without oral feeding through minimally invasive techniques and the avoidance of surgeries, which involve more risks. The enteral nutrition modalities consist of endoscopy-guided nasoenteric tube (ENET), percutaneous endoscopic gastrostomy (PEG), percutaneous endoscopic gastrostomy with jejunal tube extension (PEG-J), direct percutaneous endoscopic jejunostomy (DPEJ) or endoscopic ultrasound (EUS)-guided gastroenterostomy. Full article

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2021

Jump to: 2024, 2023, 2022

8 pages, 1400 KiB

Open AccessArticle

Should the Endoscopic Restrictions during COVID-19 Pandemic Remain Unchanged?

by Emilio Bresky, Gustavo Bresky, Domingo Lancellotti, Juan Madariaga, Sebastian Licuime, Paulette Palma, Fabian Saez, Maria Jose Rojas and Luis Seijas

Gastroenterol. Insights 2021, 12(3), 358-365; https://doi.org/10.3390/gastroent12030034 - 25 Aug 2021

Cited by 2 | Viewed by 3002

Abstract

(Background) Endoscopic procedures are interventions that have been defined as carrying a high-risk of infection with COVID-19. Most endoscopy units restrict their activity based on pre-endoscopic diagnosis. (Objective) To determine the consequences of endoscopic restrictions as a result of the COVID-19 pandemic and [...] Read more.

(Background) Endoscopic procedures are interventions that have been defined as carrying a high-risk of infection with COVID-19. Most endoscopy units restrict their activity based on pre-endoscopic diagnosis. (Objective) To determine the consequences of endoscopic restrictions as a result of the COVID-19 pandemic and their impact on digestive cancer diagnosis. (Design) A comparison of upper digestive endoscopies and colonoscopies with gastrointestinal cancers diagnosed between three endoscopic centers, two of which restricted their procedures and one that did not but performed the procedures under a strict protocol. (Setting) A retrospective analysis was performed collecting data between 15 March 2019 and 15 August 2020. Two-factor ANOVA and a Tukey’s a posteriori test were used as statistical tests. (Main outcome measures) There was variation in gastrointestinal cancer diagnosis between 2019 and 2020, considering the endoscopic procedures performed each year. (Result) There was a significant decrease in the total endoscopic procedures performed between 2019 and 2020 (p < 0.001), the result of reduced testing at the two centers (p < 0.001) with pre-endoscopic restrictions, which was not compensated for by a slight increase in procedures at the center without restrictions (p = 0.139). Regarding the total cancers diagnosed, while a significant decrease was observed for the two centers with pre-endoscopic restrictions (p = 0.007), a significant increase was registered in the center that maintained its endoscopic productivity (p < 0.001). After 851 procedures (537 upper digestive endoscopies and 314 colonoscopies) there was no evidence of COVID-19 infection in the endoscopic staff. (Conclusion) Endoscopic restrictions based on pre-endoscopic diagnosis should be reassessed in consideration of local pandemic situations, and a balance should be sought between COVID-19 infection risk and the detrimental delay of potential cancer diagnosis. Full article

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8 pages, 6679 KiB

Open AccessCase Report

Multi-Organ Involvement of Immunoglobulin G4-Related Disease

by Elleuch Nour, Aya Hammami, Nabiha Missaoui, Ahlem Bdioui, Wafa Dahmani, Wafa Ben Ameur, Ahlem Braham, Salem Ajmi, Aida Ben Slama, Mehdi Ksiaa, Hanen Jaziri, Sihem Hmissa and Ali Jmaa

Gastroenterol. Insights 2021, 12(3), 350-357; https://doi.org/10.3390/gastroent12030033 - 21 Aug 2021

Cited by 4 | Viewed by 2918

Abstract

Immunoglobulin G4-related disease (IgG4-RD) is a fibroinflammatory condition of unknown etiology, with presumed autoimmune mechanisms. It is characterized by high levels of IgG4 and variable clinical manifestations. It can involve one or multiple organs. Herein, we reported the case of a 62-year-old man [...] Read more.

Immunoglobulin G4-related disease (IgG4-RD) is a fibroinflammatory condition of unknown etiology, with presumed autoimmune mechanisms. It is characterized by high levels of IgG4 and variable clinical manifestations. It can involve one or multiple organs. Herein, we reported the case of a 62-year-old man with three organs involvement. He initially presented with recurrent jaundice. Laboratory analysis revealed cholestasis, high gamma-globulin levels, renal failure, and proteinuria. Abdominal Magnetic Resonance Imaging (MRI) showed segmental strictures of the left intrahepatic bile ducts and the wirsung duct with an increased volume of the pancreas and diffuse bilateral enlargement of the kidneys. Laboratory tests revealed high IgG4 levels (770 mg/dL). Based on the biological and radiological findings, we have suggested the diagnosis of systemic IgG4-related disease involving bile ducts, the pancreas, and probably the kidneys. Renal biopsy revealed lymphoplasmacytic infiltrate and fibrosis, but no IgG4-positive cell. The patient received corticosteroid therapy with a complete resolution of all symptoms and a rapid normalization of all blood tests. The present case underlines the complexity of IgG4-RD because of its variable clinical presentation. The diagnosis is challenging and should be carefully assessed for possible multi-organ involvement. Full article

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7 pages, 548 KiB

Open AccessArticle

What Is the Correct Way to Manage Children Requiring Gastrostomy? Single Center Experience

by Carmine Noviello, Mercedes Romano, Edoardo Bindi, Giovanni Cobellis, Stefano Nobile and Alfonso Papparella

Gastroenterol. Insights 2021, 12(3), 329-335; https://doi.org/10.3390/gastroent12030030 - 16 Jul 2021

Viewed by 2874

Abstract

Children with complex medical issues often present different comorbidities that cause feeding difficulties. Gastrostomy is often helpful, and should be performed when nutritional supplementation is necessary for longer than 6 weeks. Recently, different techniques have been used for gastrostomy in children. The authors [...] Read more.

Children with complex medical issues often present different comorbidities that cause feeding difficulties. Gastrostomy is often helpful, and should be performed when nutritional supplementation is necessary for longer than 6 weeks. Recently, different techniques have been used for gastrostomy in children. The authors report on their experiences regarding the diagnostic and therapeutic management of children requiring gastrostomy. All patients managed in the last 10 years were reviewed, retrospectively. Everyone underwent investigation to exclude gastroesophageal reflux disease (GERD). A total of 148 patients: 111 cases (75%) were neurologically impaired patients, 18 (12%) had complex heart disease, 10 (6%) had metabolic diseases, 4 (3%) had fibrosis cystic, 4 (3%) had muscle disease, and one had chromosomopathy. After investigation, 49 patients had GERD. PEG was performed in 101 cases (68%), laparo-assisted gastrostomy was performed in 44 cases (29.7%), open gastrostomy was performed in three cases. At follow-up, all patients reported weight gain, but 13 cases had major complications. Currently, the surgeon has the possibility of choosing between several safe techniques for gastrostomy. In our experience, PEG is the most useful technique for patients without GERD, while a laparo-assisted technique is better for patients who require laparoscopic fundoplication. Full article

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5 pages, 2006 KiB

Open AccessCase Report

Peritoneal Tuberculosis Mimicking Ovarian Cancer: Gynecologic Ultrasound Evaluation with Histopathological Confirmation

by Francesca Arezzo, Gerardo Cazzato, Vera Loizzi, Giuseppe Ingravallo, Leonardo Resta and Gennaro Cormio

Gastroenterol. Insights 2021, 12(2), 278-282; https://doi.org/10.3390/gastroent12020024 - 12 Jun 2021

Cited by 9 | Viewed by 3736

Abstract

Peritoneal tuberculosis (TBP) is a very rare condition, accounting for about 1–2% of all tuberculosis cases. The diagnosis of TBP can be easily mistaken for advanced ovarian cancer (AOC) or peritoneal carcinoma because of overlapping laboratory and clinical findings. We reported the ultrasound [...] Read more.

Peritoneal tuberculosis (TBP) is a very rare condition, accounting for about 1–2% of all tuberculosis cases. The diagnosis of TBP can be easily mistaken for advanced ovarian cancer (AOC) or peritoneal carcinoma because of overlapping laboratory and clinical findings. We reported the ultrasound characteristics of a case of TBP in a 67-year-old woman who presented to our institute with a 1-month history of intermittent lower abdominal pain, fever, and asthenia. Overall, 20 biopsy-retrieved specimen histopathological features were suggestive of peritoneal tuberculosis. Gynecologic ultrasound revealed increased adnexa with multiple nodular formations spread across the surface, suggestive of caseous nodules. Although this is a rare occurrence, clinicians should consider TBP as a differential diagnosis of ovarian or peritoneal cancer. Full article

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25 pages, 29120 KiB

Open AccessReview

40 Years of Helicobacter pylori: A Revolution in Biomedical Thought

by Ioannis Alexandros Charitos, Donato D’Agostino, Skender Topi and Lucrezia Bottalico

Gastroenterol. Insights 2021, 12(2), 111-135; https://doi.org/10.3390/gastroent12020011 - 24 Mar 2021

Cited by 54 | Viewed by 10287

Abstract

Background: Various microorganisms such as bacteria, virus, and fungi can infect humans and cause not just a simple infection but septic conditions, organ dysfunction, and precancerous conditions or cancer involving various organ systems. After the discovery of the microscope, it was easier to [...] Read more.

Background: Various microorganisms such as bacteria, virus, and fungi can infect humans and cause not just a simple infection but septic conditions, organ dysfunction, and precancerous conditions or cancer involving various organ systems. After the discovery of the microscope, it was easier to discover and study such microorganisms, as in the case of Helicobacter pylori, a pathogen that was seen in the distant era of the nineteenth century but without being recognized as such. It took 100 years to later discover the pathogenesis and the cancer that this bacterium can cause. Since it was discovered, until today, there has been a continuous search for the understanding of its pathogenetic mechanisms, and the therapeutic approach is continuously updated. Methods: We investigated how diagnosis and therapy were dealt with in the past and how researchers sought to understand, exactly, the pathogenetic biomolecular mechanisms of H. pylori, from the genesis of the infection to the current knowledge, with an analysis of carcinogenic mechanisms in the stomach. We have examined the scientific evolution of the knowledge of the disease over these 40 years in the gastroenterological and pharmacological fields. This was possible through a search in the databases of Medline, the WHO website, the Centers for Disease Control and Prevention (CDC) website, PubMed, and Web of Science to analyze the earlier and the latest data regarding H. pylori. Results: With the scientific discoveries over time, thanks to an increasing number of progressions in scientific research in the analysis of the gastric mucosa, the role of Helicobacter pylori in peptic ulcer, carcinogenesis, and in some forms of gastric lymphoma was revealed. Furthermore, over the years, the biomolecular mechanism involvement in some diseases has also been noted (such as cardiovascular ones), which could affect patients positive for H. pylori. Conclusions: Thanks to scientific and technological advances, the role of the bacterium H. pylori in carcinogenesis has been discovered and demonstrated, and new prospective research is currently attempting to investigate the role of other factors in the stomach and other organs. Cancer from H. pylori infection had a high incidence rate compared to various types of cancer, but in recent years, it is improving thanks to the techniques developed in the detection of the bacterium and the evolution of therapies. Thus, although it has become an increasingly treatable disease, there is still continuous ongoing research in the field of treatment for resistance and pharma compliance. Furthermore, in this field, probiotic therapy is considered a valid adjuvant. Full article

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