Volume 77 - 2014 - Fasc.2 - Original articles
The incidence of HPV infection in anal cancer patients in Greece
Background and aim of the study : Although anal cancer repre- sents a relatively uncommon malignancy, its incidence over the last five decades, has been reported as increased for both sexes, world- wide. Human papillomavirus (HPV) infection has been shown to be a major cause for its development. The aim of the present study is to report on clinical, epidemiological and virological data of squa- mous anal cancer in Greek patients.
Patients and Method : Between January 2002 and December 2010, 11 Greek patients (6 females) who were diagnosed as suffer- ing from squamous cell anal or perianal cancer, were treated in our Hospital. Formalin fixed paraffin embedded tissue samples, ob- tained at the time of the anal biopsy or surgery, were analyzed by PCR in order to identify the presence as well as the type of HPV infection.
Results : Overall, the presence of HPV DNA was detected in 6 out of the 11 patients (54.5%). The "highrisk" HPV DNA was detected in 3 of them (2 women and 1 man), while the "lowrisk" HPV DNA was detected in the remaining three (2 women and 1 man).
Conclusion : The incidence of HPV infection in squamous cell anal cancer Greek patients, is lower than other Western countries, probably reflecting differences in sexual habits in the Greek population. (Acta gastroenterol. belg., 2014, 77, 213-216).
Can zinc levels predict response to pegylated-interferon and ribavirin therapy in hepatitis c genotype 4 infected Egyptian patients ?
Background and Aims: Zinc has been found to be low in chronic hepatitis patients. Its level was correlated with response to Interferon/ribavirin therapy in patients infected with hepatitis C genotype 1. In Egypt, inexpensive predictors to treatment response in Hepatitis C genotype 4 infected patients are desperately needed. We aim to explore if pretreatment zinc serum levels correlate with response to pegylated- interferon and ribavirin therapy in Egyptian patients.
Methods : This is an observational prospective study where 57 treatment naïve hepatitis C genotype 4 infected patients that were Hepatitis B and Human Immunodeficiency virus negative were recruited in a hospital setting. The study was performed from October 2010 till June 2012. Patients had Liver biopsy and basic biochemical profiles were performed pretreatment for all patients. Treatment consisted of 48 weeks of pegylated-interferon-alpha2a and ribavirin therapy. Blood samples were withdrawn from 21 healthy subjects to compare zinc levels and other biochemical markers. Patients were followed up to 72 weeks.
Results : Pretreatment serum zinc levels were significantly lower in hepatitis C infected patients compared to healthy volunteers (p < 0.05). Moreover, zinc levels correlated to sustained virological response in treated patients (p = 0.00).
Conclusion : Serum zinc levels can be used as an inexpensive predictor to effective Pegylated-interferon/ribavirin therapy in Egyptian patients infected with Hepatitic C genotype 4. (Acta gastroenterol. belg., 2014, 77, 217-223)
Unsedated transnasal versus conventional oral endoscopy in endoscopy naïve patients
Background and study aims : Unsedated transnasal upper endos- copy (TNE) has been suggested as a more comfortable and safer method than unsedated transoral endoscopy (Toe). However, the numbers of comparative trials are limited. The current study aimed to assess the tolerability, safety, and efficacy of TNE in endoscopy naïve patients.
Patients and methods : The current study was designed as a randomized, prospective, parallel arm trial including all eligible patients referred for upper endoscopy. Patients were randomized with a 1:1 ratio to undergo either unsedated Toe using a standard endoscope or unsedated TNE using an ultrathin endoscope. Post- procedure, all patients were asked to complete a questionnaire to assess pain, discomfort, distress and tolerability using a 10 cm visual analog scale (VAS). Patients' expectations and future prefer- ences were also determined by multiple choice questions. Endo- scope insertion rate, procedure duration, and side-effects were recorded for each patient.
Results : Each group included 200 patients. With the exception of nasal pain, mean VAS scores were significantly lower in TNE patients when compared to Toe patients (p = 0.0001). 85% and 54.5% of patients in TNE and Toe groups, respectively, found the procedure better than expected (p = 0001). A repeat procedure was significantly more acceptable for TNE than Toe (82.4% and 60.5%, respectively). Endoscope insertion failed in 3.5% of TNE patients. Mild epistaxis was observed in 4% of TNE patients.
Conclusion : Unsedated TNE was tolerated better in endoscopy naïve patients than unsedated Toe in a large parallel arm trial. (Acta gastroenterol. belg., 2014, 77, 224-228).
The prognostic significance of clinicopathological features and apoptosis inhibi- tor proteins in pancreas ductal adenocarcinoma
Introduction: Pancreas ductal adenocarcinoma (PDAC) is among tumors with unfavorable prognosis. The aim of this study was to determine potential prognostic factors in PDAC.
Materials and methods : We retrospectively evaluated a total of 117 cases according to clinicopathological parameters and survivin and livin expression. We investigated the relationship between these parameters and their prognostic significance.
Results : In univariate analysis, lymph node metastasis, surgical margin positivity, tumor size over 4 cm and survivin expression were associated with poorer survival but livin expression was not correlated with survival-time. In multivariate analysis, only lymph node metastasis was independent factor predicting a poorer out- come.
Conclusions : In present study, the lymph node metastasis was the strongest predictor of survival. Our finding suggest that sur- vivin could be a target for the treatment of advanced stage resect- able PDAC. Our results need to be supported by studies on larger series with advanced techniques. (Acta gastroenterol. belg., 2014, 77, 229-234).
Helicobacter pylori eradication reduces microalbuminuria in type-2 diabetic patients : a prospective study
Methods : Consecutive patients with dyspepsia, type 2 diabetes mellitus and microalbuminuria were recruited. Upper gastrointes- tinal endoscopy and rapid urease test (H. pylori fast) were per- formed for detecting H. pylori infection. Patients with H. pylori in- fection were given triple treatment. Urea breath tests were performed for all patients after eradication treatment. According to the eradication status, patients were divided into two groups, as H. pylori negative, group 1 (successful eradication group) and H. pylori positive, group 2 (unsuccessful eradication group). Twenty- four hour urine was also collected from all patients at baseline and after H. pylori eradication treatment.
Aim : To evaluate the effect of Helicobacter Pylori (H. pylori) eradication on microalbuminuria in type 2 diabetic patients.
Results : A total of 69 patients were included in the study. There were no significant differences between groups for anthropometric measurements and laboratory tests at baseline (p > 0.05). An ex- pected significant difference was found for microlabuminuria and fasting glucose between the two groups. Microalbuminuria and fasting glucose levels were signicantly reduced in the H. pylori negative group compared with the H. pylori positive group after eradication treatment (p < 0.05). Although there was no significant decline in HbA1c levels in the H. pylori negative group, there were relatively lower HbA1c levels compared with baseline for both groups. The rate of attaining normoalbuminuria after eradication was significantly higher in group 1 compared to group 2 (p < 0.05).
Conclusion : H. Pylori eradication was found to have a favorable effect on reducing microalbuminuria in diabetic patients. (Acta gastroenterol. belg., 2014, 77, 235-239