1,720,971 research outputs found
RIBAVIRIN PRIMING ENHANCES EFFICACY OF CHRONIC HEPATITIS C RE-TREATMENT IN PATIENTS WHO HAD NOT RESPONDED TO PREVIOUS COMBINATION THERAPY
No full textTraction-assisted endoscopic submucosal dissection of a neuroendocrine tumor in the gastric body of a patient with autoimmune gastritis
Full text linkThis video case underscores the feasibility of traction-assisted ESD for large gastric NETs in AAG. By providing stable exposure of the submucosal plane, traction can enable precise dissection and secure margin clearance while preserving muscular integrity. Such an approach may be particularly valuable in patients with chronic inflammatory conditions that predispose them to multiple or recurrent gastric lesion
Loss and seroconversion of hepatitis B surface antigen after vaccine therapy in chronic hepatitis B patients treated with nucleoside/nucleotide analogues.
No full textUnderwater traction-assisted endoscopic submucosal dissection of a neuroendocrine tumor in the duodenal bulb
Full text linkN/
Influence of the Microbiota Through the Gut-Brain Axis in Neurological Diseases
No full textThe gut microbiotaMicrobiota strongly interacts with brain, creating the microbiota gut-brain axis. The central nervous system (CNS) is significantly impacted by the gut microbiotaMicrobiota through various pathways, including activation of the vagus nerve, production of metabolites with neuroendocrine functions, and stimulation of immunological responses. Conversely, the brain, in conjunction with the enteric nervous system, exerts control over gastrointestinal tract motility and permeability, intestinal mucus secretion and immune response. Therefore, also the brain has an influence on composition of gut microbiota. Biological communication between the gastrointestinal and CNS is crucial in the pathophysiology and pathogenesis of numerous conditions affecting these systems. As such, the expanding field of microbiota-gut-brain axis research provides a promising framework to further expanding our understanding of disease mechanisms. This chapter aims to synthesize current knowledge in this domain, highlighting recent preclinical and clinical evidence linking the intestinal microbiome and immune system to various neurological disorders. Specifically, we examine involvement of the microbiotaMicrobiota in the onset of several prominent neurological diseases. Additionally, we discuss emerging studies exploring treatments for neurological diseases through manipulation of the gut microbiota such as probioticsProbiotics, prebioticsPrebiotics, synbiotics, and fecal microbiotaMicrobiota transplantation—leveraging interactions along the gut-brain axis
Higher adenoma recurrence rate after left- versus right-sided colectomy for colon cancer.
No full textBACKGROUND:
Patients with history of colonic resection for cancer have an increased risk of the development of metachronous malignant and premalignant lesions. Scanty data are reported on detection rates of premalignant lesions during colonoscopy surveillance in this setting.
OBJECTIVE:
To assess the risk of metachronous precancerous lesions developing in patients with previous colonic surgery for cancer according to the resection type.
DESIGN:
Retrospective study.
SETTING:
Two academic centers in Italy.
PATIENTS:
A total of 441 patients; 256 with previous left-sided colectomy (LCR) (LCR group) and 185 with previous right-sided colectomy (RCR) (RCR group).
INTERVENTIONS:
Second surveillance colonoscopy.
MAIN OUTCOME MEASUREMENTS:
Polyp and adenoma detection rates.
RESULTS:
At least 1 adenoma was diagnosed in 76 of 256 patients (30% adenoma detection rate) and in 35 of 185 patients (19% adenoma detection rate) in the LCR and RCR groups, respectively (P = .014), yielding an odds ratio of 1.83 (95% confidence interval, 1.16-2.89). Corresponding figures for the polyp detection rate were 39% and 25%, respectively (P = .002; odds ratio 1.97; 95% confidence interval, 1.30-3.00).
LIMITATIONS:
Retrospective study with colonoscopy baseline information missing.
CONCLUSIONS:
Patients who have undergone LCR are at higher risk of the development of adenomas than those who have undergone RCR. If this result is confirmed by large prospective studies, surveillance programs could be targeted according to the type of colonic resection, with longer intervals for patients with previous RCR compared with LCR
Gastric metastasis from ovarian adenocarcinoma presenting as a subepithelial tumor and diagnosed by endoscopic ultrasound-guided tissue acquisition
No full textWe describe an uncommon case of a patient with a metastatic adenocarcinoma of ovarian origin presented as a gastric subepithelial tumor (SET) and that was diagnosed by endoscopic ultrasound fine-needle biopsy (EUS-FNB). Malignant gastric lesions are rarely metastatic and the primary tumor is mainly breast, lung, esophageal cancer or cutaneous melanoma. Gastric metastasis from ovarian cancer is unusual, presenting synchronously with the primary tumor but also several years later than the initial diagnosis. From an endoscopic point of view, gastric metastasis does not present specific features. They may mimic both a primary gastric tumor or, less frequently, an SET. This case demonstrates the importance of EUS-FNB in distinguishing SETs and how this may alter treatment and prognosis
Role of Endoscopic Ultrasound in the local staging of gastrointestinal neuroendocrine tumors candidates to endoscopic resection.
Full text linkOggetto: Ruolo dell’ ecoendoscopia (EUS) nello studio dei tumori neuroendocrini del tratto digestivo è la stadiazione locoregionale basata sulla valutazione dell’ estensione di profondità di parete (T) e l’ interessamento dei linfonodi loco-regionali (N) con un’accuratezza diagnostica del 94-100%. La resezione endoscopica è un’ opzione di trattamento. Scopo dello studio è stato valutare l’ accuratezza diagnostica dell’ EUS nella stadiazione locale dei tumori neuroendocrini gastrici, duodenali e rettali macroscopicamente suscettibili di resezione endoscopica e valutare l’efficacia della resezione endoscopica.
Materiali e metodi: Studio retrospettivo condotto su una coorte consecutiva di pazienti con diagnosi di neoplasia neuroendocrina del tratto gastroenterico afferenti all’ Istituto Europeo di Oncologia di Milano.
Risultati: Sono stati sottoposti ad EUS 21 pazienti per un totale di 22 lesioni da Settembre 2001 a Gennaio 2016. 21 lesioni erano confinate alla sottomucosa, soltanto in una lesione gastrica è stato posto il dubbio di infiltrazione superficiale della tonaca muscolare propria e in una lesione del retto riscontro di una linfoadenopatia di aspetto secondario. 11 lesioni erano nello stomaco (NET gastrico di tipo 1), 5 nel duodeno e 5 nel retto. Le lesioni sono state asportate per via endoscopica in pezzo unico intero. All’ analisi istopatologica 21 lesioni erano limitate alla sottomucosa, tranne il caso con dubbia infiltrazione della tonaca muscolare che presentava interessamento dello strato muscolare superficiale. In 2 dei 21 è stato valutato l’ interessamento linfonodale dopo resezione chirurgica. In 10 di 22 lesioni con infiltrazione dei margini di resezione non si è riscontrata recidiva di malattia durante il follow-up (media 34 mesi, 3-126 mesi).
Conclusioni: L’ EUS è una metodica valida nella valutazione della resecabilità endoscopica dei NETs gastrici di tipo 1, del bulbo e del retto. La resezione endoscopica è risultata efficace nel trattamento di queste neoplasie anche in presenza di infiltrazione dei margini di resezione.Background and aim: Diagnostic role of endoscopic ultrasound (EUS) in gastrointestinal neuroendocrine tumors (GE-NETs) is the local staging based on the assessment of wall depth (T) and of lymph nodes metastasis (N). Diagnostic accuracy of EUS in T-staging is 94-100%. Endoscopic resection is a treatment option in selected cases. Aim of the current study was to evaluate diagnostic accuracy of EUS in the local staging of GE-NETs candidates to endosciopic resection and the efficacy of endoscopic resection in gastrointestinal neuroendocrine NETs’ treatment.
Methods: This is a retrospective analysis of a prospectively collected database. Patients with GE-NETs that underwent EUS and endoscopic resection at Istituto Oncologico Europeo (IEO) were included.
Results: From September 2001 to January 2016, 21 patients for a total of 22 GE-NETs underwent EUS: 21 GE-NETs were confined to the submucosa layer; 1 case presented a doubtful involvement of the proper muscolaris layer. 11 NETs were in the stomach, 5 NETs in the duodenum and 5 NETs in the rectum. All but one rectal NET case were negative for metastatic lymph nodes. All the 22 lesions were endoscopically resected in one piece by endoscopic resection. The histological analysis confirmed that twenty-one lesions were confined to the submucosa layer and that one case was involved the proper muscolaris layer. The involvement of lymph nodes was evaluated in only the two cases who underwent surgical resection. Ten out of 22 lesions had positive margins at the histological analysis but no recurrence were observed during follow-up (mean 34 months; range 3-126).
Conclusions: EUS is useful for estimating the depth of invasion of type 1 gastric neuroendocrine tumor, duodenal and rectal neuroendocrine tumors and for determining whether endoscopic resection is indicated. Endoscopic resection is effective in gastrointestinal neuroendocrine NETs’ treatment
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