Search

Background: Surveillance of gastric precancerous lesions (GPL) may reduce gastric cancer (GC)-related mortality, but some patients with GPL are lost to follow-up. Objective: The aim of this study was to evaluate the feasibility and efficacy of a “phone-call” strategy in surveillance of the lost to follow-up patients. Patients and Methods: Among all the patients diagnosed with GPL (atrophic gastritis, intestinal metaplasia, low-grade dysplasia) between 2000 and 2015, we identified those who should undergo surveillance endoscopy according to the current guidelines. They were contacted by telephone and invited to undergo endoscopy with gastric biopsies for histological analysis. Results: Among 535 patients with GPL, 134 were contacted. Sixty-two (46%) could not be joined, 36 did not have endoscopy for other reasons, and finally, 36 patients (22 males, median age 65 years) were included. After the median time interval of 57 months between 2 endoscopies, 18 patients showed stability, 11 regression, and 7 progression of GPL, including 1 patient who developed GC. Conclusion: Despite several telephone calls, only one-third of the contacted patients could be brought to surveillance endoscopy. Most of the patients showed stability of GPL, but 1 progressed to GC and could be successfully treated.

International audience; Background: Analysis of serum biomarkers for the assessment of atrophic gastritis (AG), considered as gastric precancerous lesion, is of growing interest and recommended by current guidelines. Our aim was to evaluate the diagnostic performance of a panel of biomarkers (GastroPanel®) for the detection of AG in France, a country of a low gastric cancer (GC) incidence. Material and Methods: In this prospective, multicenter, cross-sectional study, consecutive patients considered at increased risk of GC and undergoing upper endoscopy with gastric biopsies were included. Blood samples were collected for the analysis of GastroPanel® (association of Pepsinogens I and II, Gastrin-17, and Helicobacter pylori serology) using ELISA. The results of GastroPanel® were compared to the results of histology considered as the reference. Results: Between 2016 and 2019, 344 patients (148 cases with AG, 196 controls without AG) were included. Sensitivity, specificity, positive, and negative predictive values for the detection of AG by GastroPanel® were of 39.9% (95% CI 31.9; 48.2), 93.4% (95% CI 88.9; 96.4), 81.9 (95% CI 71.1; 90.0), and 67.3 (95% CI 61.4; 72.8), respectively. The sensitivity was significantly higher for the detection of severe AG [60.8% (95% CI 46.1; 74.6) P =.015] and corpus AG [61.0% (95% CI 49.2; 72.0), P =.004]. Diagnostic performances of GastroPanel® tended to be better than those of Pepsinogen I alone, but the difference did not reach statistical significance (P =.068). Conclusion: Serum pepsinogen and GastroPanel® tests show promising results for the detection of AG, especially of corpus AG and severe AG, in patients at high risk of GC in France.

Pravilna prehrana ključna je za očuvanje dobroga zdravlja odraslih osoba te čini osnovu pravilnog rasta i razvoja djece i adolescenata. Danas je poznato da su neadekvatna prehrana i nedovoljna tjelesna aktivnost među vodećim uzrocima velikog broja slučajeva morbiditeta i mortaliteta. Bolesti i stanja koja se posebno vežu uz neadekvatnu prehranu uključuju dijabetes tipa 2, dislipidemiju, kardiovaskularne bolesti, osteoporozu, pretilost te neke oblike raka. Pravilno izbalansirana prehrana i adekvatna tjelesna aktivnost trebale bi osigurati dobro zdravlje većini pojedinaca. Na ovoj premisi, a s ciljem edukacije javnosti, kreirane su prehrambene smjernice koje sažimaju zaključke dostignuća iz znanosti o prehrani, i to tako da ih u obliku preporuka lako može prihvatiti i primijeniti šira javnost. Prehrambene smjernice često se, radi lakše interpretacije, grafički prikazuju piramidom prehrane s posebno naznačenim pojedinim grupama namirnica.

Mjerenje unosa hrane i nutrijenata najčešća je indirektna metoda procjene nutritivnog statusa. Krajnji cilj mjerenja unosa hrane i nutrijenata je zdravlje ljudi. Odabir dijetetičke metode ovisi o specifičnom problemu u kliničkim uvjetima, u znanstvenoj studiji o povezanosti prehrane i zdravlja ili kad je cilj unaprijediti zdravlje pojedinca ili opće populacije. Razlike postoje ovisno o cilju ispitivanja, željenoj preciznosti, populaciji koja se promatra, razdoblju i dostupnim sredstvima. Najčešće dijetetičke metode su 24-satno prisjećanje, dnevnik prehrane i upitnik o učestalosti konzumiranja hrane i pića. Primjena dviju ili više metoda istodobno daje točnije podatke. Prikupljene podatke važno je interpretirati uzimajući u obzir prednosti i nedostatke upotrijebljene metode. Podaci o unosu hrane i nutrijenata služe za procjenu nutritivnog statusa u kombinaciji s antropometrijskim i biokemijskim parametrima. Planiranje prehrane podrazumijeva sastavljanje obroka za jedan ili više dana držeći se osnovnih principa planiranja prehrane: kontroliran energetski unos, adekvatnost, uravnoteženost, nutritivnu gustoću, umjerenost i raznolikost.