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This article, published in the journal Endoscopy, evaluates the efficacy of a standard Argon Plasma Coagulation (APC) catheter after submucosal injection for the ablation of Barrett's esophagus (BE) with low-grade dysplasia (LGD). The study included 34 patients, primarily males, with an average age of 56.4 years. The results showed that the APC catheter was safe and tolerable for the ablation of flat BE with LGD. Factors such as not smoking and being a naive patient for BE treatment were found to be favorable for BE eradication. Additionally, older age at the diagnosis was a favorable predictor for dysplasia eradication. [Extracted from the article]

Background Gastrointestinal angiodysplasias ( GIADs) may be the cause of recurrent bleeding, despite endoscopic treatment. Aim To evaluate the effect of long-acting somatostatin analogues on blood transfusion requirements, in patients with refractory bleeding due to GIADs. Methods Consecutive patients with recurrent bleeding from GIADs were enrolled. They received somatostatin analogue treatment for at least 6 months. The efficacy was evaluated in terms of blood transfusions, frequency of bleeding episodes and haemoglobin level during 6 months of treatment (Period During) compared to a 6-months' period before treatment (Period Before). Results Fifteen patients were enrolled from 2007 to 2010. The median duration of somatostatin analogue treatment was 12 months (range: 6-36). The number of transfusions significantly decreased in Period During compared with Period Before [median number: 2 (0-14) vs. 10 (6-24); P < 0.001]. The percentage of patients who experienced a bleeding event was lower during somatostatin analogues treatment (20% vs. 73%; P = 0.01). The mean haemoglobin level was significantly higher when somatostatin analogues were offered [median: 10 g/dL (9-13) vs. 7 (5-8.5); P < 0.001]. None of the patients discontinued treatment due to side effects. Conclusions Long-acting somatostatin analogues treatment decreased transfusion needs in patients with refractory bleeding from gastrointestinal angiodysplasias. Bleeding episodes were limited and haemoglobin improved during treatment. Long-acting somatostatin analogues may represent an option for the management of patients with chronic bleeding due to gastrointestinal angiodysplasias. [ABSTRACT FROM AUTHOR]

Pregnancy in women with liver cirrhosis is an infrequent situation. In general the incidence of cirrhosis in pregnancy is very low and it is estimated approximately about 1 in 5,950 pregnancies. We report a descriptive management of pregnancy in a woman suffering from chronic viral hepatitis B with D and C coinfection exacerbated finally to severe cirrhosis of the liver. Caesarean section was performed giving birth to a viable male infant. Two months after the operation the patient underwent a liver transplantation with good outcome. Management of such severe cases requires a multidisciplinary medical approach. Data regarding cirrhosis caused by chronic viral agents in pregnancy are limited. [ABSTRACT FROM AUTHOR]

The article focuses on the case of 72-year-old man with cardiac adenocarcinoma, who developed malignant esophageal stricture following metal stent and radiation therapy to treat pulmonary metastases. It states that the patient have normal vital signs, however flumazenil treatment did not make him recover. It adds that a computed tomography (CT) of the brain revealed bilateral multifocal cerebral air embolism. The patient developed pneumocephalus due to gas entry through the venous system.

There are several recent reports suggesting a decrease in the incidence of GDU. The aim of our study was to evaluate if there are changes in the prevalence of endoscopic diagnosis of GDU or E after the wide application of Hp eradication regimens. Patients & Methods: We analyzed all the endoscopic reports and related files of all the patients who had an UGI endoscopy during the years 1993, 1997 and 2001. Our department is situated in a central hospital of Athens, it belongs to the National Health System (NHS) and it has an open access for all beneficiaries of NHS. Results: Total number of fiberoscopies (UGI), gastric/duodenal ulcers (GDU) and E with the corresponding LA classification (A/B/C/D) are shown on the table. The groups were comparable for age, tobacco and alcohol consumption. Valuable information on Hp status in patients with endoscopic lesions were available in only 58% during 1993, while this increased dramatically during 1997 (96%) and 2001 (97%). Among them the % of Hp(+) patients was 50%, 42% and 51% for E, 77%, 65% and 73% for GU and 90%, 89% and 85% for DU for the 3 periods respectively. NSAID's consumption was not modified according to the files' data. Complications decreased only in 2001 (205, 196, 68). Conclusions: Since 1993, 1) The total number of UGI procedures has not changed, 2) The accurate control on Hp status has dramatically increased, 3) Neither the prevalence of GDU and E at endoscopy nor their Hp status were modified, 4) Non variceal hemorrhage decreased during 2001, regardless of the same NSAID's consumption. [ABSTRACT FROM AUTHOR]

Aim of the study: To evaluate possible differences in inflammation and intestinal metaplasia in patients with duodenal ulcer (DU) and reflux esophagitis (RE). Patients and Methods: 90 patients with DU, all Hp(+) and 98 patients with RE, 54 Hp(+) and 44 Hp(-) were enrolled in the study. Biopsy specimens obtained from gastric antrum (A), fundus (F) and cardia(C) were examined with Hematoxylin-Eosin, modified Giemsa, PAS-Alcian Blue and HID-Alcian Blue stains. The grade and activity of inflammation were evaluated according to updated Sydney System. Serology for CagA characterization was performed in all Hp(+) patients. Stat: chi-square. Results: The number of patients with the different degrees (0/1/2/3) of the grade and the activity of inflammation as well as the presence and the extent of intestinal metaplasia (IM) are shown in the table. CagA seropositivity was 90% for DU patients but only 40% for REHp(+). Conclusions: 1) The grade and activity of the inflammation of the cardia are more severe in DU than in REHp(+) patients. 2) The grade and activity of the cardia inflammation are more severe in REHp(+) than in REHp(-) patients. 3) There is no difference in the presence of IM neither between DU and REHp(+) nor between REHp(+) and REHp(-) patients. 4) the prevalence of CagA seropositivity is higher in DU than in REHp(+) patients. [ABSTRACT FROM AUTHOR]

Aim: To genotype in terms of cagA and vacA status, H. pylori clinical strains, isolated from children and adults in the Greek population. Materials and Methods: 45 clinical strains from children and 56 from adult patients were isolated from gastric biopsies following gastroscopy. The presence of cagA as well as subtyping of vacA mid-and signal-region was effected by PCR on genomic DNA as described by Atherton et al, 1999 and Yamaoka et al., 1999. Results: 84 (83%) out of 101 strains were detected positive for the presence of cagA (86% in the adult and 80% in the children population). Out of 79 strains analysed, 52 belonged to the vacAs1 and 27 to the vacAs2 subtype (66% and 34% respectively). Out of 74 strains analysed, 23 (31%) were of the vacAm1 and 48 (65%) vacAm2 subtypes while 3 (4%) remained untypeable. The combinations of vacA subtypes observed are summarized in the following table: We did not detect the vacAs2/m1 subtype in the sample population. Conclusion: A high frequency of cagA positive strains was observed in the Greek population. There was no significant difference in the frequency between the vacA mid- and signal-region subtypes. No statistically significant differences among the subtypes were detected between the adult and the children study groups. [ABSTRACT FROM AUTHOR]