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Colorectal cancer (CRC) remains the second most common cause of cancer-related mortality worldwide, necessitating advancements in early detection and innovative treatment strategies. MicroRNAs (miRNAs), small non-coding RNAs involved in gene regulation, have emerged as crucial players in the pathogenesis of CRC. This review synthesizes the latest findings on miRNA deregulated in precancerous lesions and in CRC. By examining the deregulation patterns of miRNAs across different stages of CRC development, this review highlights their potential as diagnostic tools. We specifically analyse the roles and diagnostic relevance of four miRNAs—miR-15b, miR-21, miR-31, and miR-146a—that consistently exhibit altered expression in CRC. The current knowledge of their role in key oncogenic pathways, drug resistance, and clinical relevance is discussed. Despite challenges posed by the heterogeneity of the research findings on miRNA deregulation and their role in CRC, integrating miRNA diagnostics into current screening methods holds promise for enhancing personalized medicine approaches. This review emphasizes the transformative potential of miRNAs in CRC diagnosis, paving the way for improved patient outcomes and novel therapeutic paradigms. [ABSTRACT FROM AUTHOR]

This study was carried out to elucidate the causes of massive outbreaks of Aurelia coerulea in Geoje Bay, Korea, from November 2022 to October 2023. Adult medusae consistently spawn with planulae, and the populations of A. coerulea in Geoje Bay could be categorized into current-year and overwintering populations. The current-year population began with the emergence of ephyrae in February and grew until October, while the overwintering population comprised a mixture of surviving current-year population and additional individuals that joined during the warm season. The size of the planulae are significantly larger than the annual average during the cold season. These results appear to be the energy accumulation of planulae for polyp formation under low water temperatures. Planulae form polyps within a temperature range of 5–25 °C, suggesting the possibility of year-round polyp recruitment. In Geoje Bay, the highest appearance rate of A. coerulea was in April (8.71 ± 12.5 ind. m−3), with ephyrae experiencing higher growth rates up to the young medusa stage. However, from April, a decline in zooplankton biomass resulted in reduced growth rates in adults, indicating that jellyfish growth was primarily regulated by food availability. Additionally, submersed oyster shells in oyster farms served as the main habitat for jellyfish polyps. A. coerulea populations were also characterized by the continuous spawning of planulae throughout the year. In conclusion, this study suggests that stable polyp habitats, abundant food supply during the initial developmental period of the population, and suitable ranges of water temperature were significant factors inducing the massive outbreak of A. coerulea in Geoje Bay, Korea. [ABSTRACT FROM AUTHOR]

Background: Endoscopic resection is currently the treatment of choice for laterally spreading tumors (LSTs). Endoscopic sub-mucosal dissection (ESD) can achieve higher enbloc resection and R0 resection, albeit at a slightly higher risk of complications. Given scarce data on ESD from India, we performed a retrospective analysis of our experience with colorectal ESD (CR-ESD) to know its clinical efficacy and complications as well as to assess the learning curve of CR-ESD in non-endemic-areas. Methods: Retrospective analysis of prospectively maintained datasheet performed. All patients with large (>2cm), complex or recurrent colorectal LST who underwent ESD at our center between 2012 and 2021 were included in the study. Various baseline lesion-related parameters, procedure-related parameters, enbloc resection (ER) rates, R0 margins and adverse event rates were retrieved. CUSUM analysis was performed to calculate the minimum required procedures to achieve competency in CR-ESD. Results: Total 149 patients were included in the study; mean patient age was 61.36±18.21 years. Most patients had lesions in rectum (n=102; 68.5%) followed by sigmoid colon (n=25; 16.8%). The mean lesion size was 46.62 ± 25.46 mm and the mean procedure duration for ESD was 219.30 ± 150.05 min. ER was achieved in 94.6% of lesions. R0 resection was achieved in 132 patients (88.6%). Overall, six (4%) adverse events were noted, of which one required surgical intervention. As many as 105 patients (70.5%) had adenomatous lesions on histology. Seventy-four patients underwent follow-up colonoscopy, of which three had a recurrence of adenomatous lesions and five had post-resection stricture requiring endoscopic dilation. CUSUM curve analysis calculated the learning curve for ESD was 47 resections for ER and 55 for the occurrence of AEs, with a composite CUSUM at 47 procedures. Conclusion: CR-ESD even in non-endemic area is associated with high en bloc resection rates, R0 resection rates and acceptable complication profile. Approximately 50 cases of CR-ESD are required to achieve competency. [ABSTRACT FROM AUTHOR]

Purpose: Commonly employed in polyp segmentation, single-image UNet architectures lack the temporal insight clinicians gain from video data in diagnosing polyps. To mirror clinical practices more faithfully, our proposed solution, PolypNextLSTM, leverages video-based deep learning, harnessing temporal information for superior segmentation performance with least parameter overhead, making it possibly suitable for edge devices. Methods: PolypNextLSTM employs a UNet-like structure with ConvNext-Tiny as its backbone, strategically omitting the last two layers to reduce parameter overhead. Our temporal fusion module, a Convolutional Long Short Term Memory (ConvLSTM), effectively exploits temporal features. Our primary novelty lies in PolypNextLSTM, which stands out as the leanest in parameters and the fastest model, surpassing the performance of five state-of-the-art image and video-based deep learning models. The evaluation of the SUN-SEG dataset spans easy-to-detect and hard-to-detect polyp scenarios, along with videos containing challenging artefacts like fast motion and occlusion. Results: Comparison against 5 image-based and 5 video-based models demonstrates PolypNextLSTM's superiority, achieving a Dice score of 0.7898 on the hard-to-detect polyp test set, surpassing image-based PraNet (0.7519) and video-based PNS+ (0.7486). Notably, our model excels in videos featuring complex artefacts such as ghosting and occlusion. Conclusion: PolypNextLSTM, integrating pruned ConvNext-Tiny with ConvLSTM for temporal fusion, not only exhibits superior segmentation performance but also maintains the highest frames per speed among evaluated models. Code can be found here: https://github.com/mtec-tuhh/PolypNextLSTM. [ABSTRACT FROM AUTHOR]

Introduction and aim: Adenoma pleomorphum (multiform adenoma) is the most popular bening tumor, that originates from the salivary glands. Neoplasm develops mainly from large salivary glands and its occurrence in the nasal cavity is rare and falls mainly in the 3-6 decade of life. Only 1% of all pleomorphic adenomas develop in the nasal and sinus cavities. Despite being a benign tumor, malignant transformation can occur in 2-10% of cases. Description of the case: We report a case of a 21-year-old female ethnically Polish patient with nasal multiform adenoma with initial diagnosis, which indicated a polyp. The final diagnosis was based on the histopathological examination of the resected lesion. The tumor was removed by an endoscopic method with no tissue margins, which may increase the risk of recurrence. Conclusions: Our case demonstrates that despite pleomorphic adenomas typically occurs in the 3rd to 6th decade of life, clinical symptoms are nondistinctive with a polyp and nasal cavity is a very rare location there should be always be increased vigilance leading to choosing best diagnostic measures to form right diagnosis. [ABSTRACT FROM AUTHOR]

The influence of metabolic dysfunction-associated steatotic liver disease (MASLD) on gallbladder polyp development in both sexes remains elusive. Therefore, to clarify the role of MASLD in gallbladder polyp development, we investigated the longitudinal association between MASLD and gallbladder polyps. In this observational study, we included 5,527 gallbladder polyp-free patients who underwent > 2 health check-ups over > 2 years. Generalized estimation equations were used to analyze associations between MASLD and gallbladder polyp development according to repeated measures at baseline and the most recent stage. Gallbladder polyp development rates in men and women were 7.5% and 5.6% (p < 0.01), respectively. MASLD was not significantly correlated with gallbladder polyp development. Regarding the association between gallbladder polyp development (men: ≥6 mm and women: ≥5 mm) and the number of MASLD components following lifestyle habits, men and women with ≥ 4 MASLD components had odds ratios of 3.397 (95% confidence interval: 1.096–10.53) and 5.338 (1.054–27.04), respectively. Higher nonalcoholic fatty liver disease fibrosis scores were associated with significant risk of gallbladder polyp development in women (1.991, 1.047–3.785). Although MASLD influence on gallbladder polyp development differs by sex, close monitoring of patients with an increasing number of MASLD components is essential to prevent gallbladder polyp development. Specifically, men with ≥ 4 MASLD components should be monitored for gallbladder polyps measuring ≥ 6 mm. [ABSTRACT FROM AUTHOR]

Deep learning techniques can accurately detect and grade abnormal findings on images from Wireless Capsule Endoscopy (WCE). However, the prediction accuracy of handcrafted or deep learning in red Lesion, polyp and ulcer diseases is still under investigation. Knowing the utility of an automatic method for abnormalities detection from WCE images and how helpful it might be for the physicians, we proposed a new methodology in approaching this field. In this paper, patches with fixed size are extracted from WCE images, then, encoded using linear projection and position embedding and passed through an embedding model in a forward pass. Moreover, triplet loss is employed to adjust the embeddings. Afterwards, the trained embedding model is exploited for classification. Two strategies are followed in the design of the embedding model namely; training from scratch and fine tuning. The presented scheme, attains satisfactory results in different datasets compared to existing approaches. The detection accuracy has reached 99.9% in some used datasets. [ABSTRACT FROM AUTHOR]

Medical image segmentation through the use of deep learning is becoming a trend targeting to automate disease detection and provide effective treatment. Traditionally huge manual efforts are associated with medical image processing by medical staff. The wide use of neural networks driven by the progressive advancement in computing power and the availability of training data provides instrumental means to automate medical image processing. A polyp refers to an abnormal growth that can occur in various parts of the body. While the majority of polyps are noncancerous or benign, there are instances where certain types can develop into cancer. Detecting and segmenting polyps is highly valuable for identifying early signs and potentially enabling more effective treatment of colon cancer. In this paper, we introduce a novel method for segmenting polyp images. The proposed method utilizes convolutional neural networks (CNNs) and employs an enhanced attention mechanism. To cater to a more granular attention view, this paper enhances the Convolutional Block Attention Module by introducing the multi‐focal channel attention (MFCA) concept, which we call MFCA. In the proposed MFCA channel attention, focal attention spots allow us to consider scattered areas of interest more effectively. To evaluate the effectiveness of the proposed method, multiple experiments are conducted on five well‐known benchmark datasets for polyp image segmentation: Kvasir, CVC‐Clinic DB, CVC‐Colon DB, CVC‐T, and ETIS‐Larib. Various testing scenarios are examined, including the impact of two focal attention spots and four focal attention spots. The experimental results demonstrated that the proposed method achieved superior performance compared to previous state‐of‐the‐art techniques on two of the benchmark datasets, and ranked second on a third dataset. [ABSTRACT FROM AUTHOR]

Gallbladder (GB) polyps are a common incidental finding on sonography, but only a small fraction of polyps become GB cancer. The Society of Radiologists in Ultrasound (SRU) consensus committee recently performed an extensive literature review and published guidelines for GB polyp follow-up/management to provide clarity among the many heterogeneous recommendations that are available to clinicians. As these guidelines have become adopted into clinical practice, challenging clinical scenarios have arisen including GB polyps in primary sclerosing cholangitis (PSC), high risk geographic/genetic patient populations, shrinking polyps, pedunculated vs sessile polyps, thin vs thick stalked polyps, vascular polyps and multiple polyps. According to the SRU guidelines, clinicians should refer to gastroenterology guidelines when managing GB polyps in patients with known PSC. If patients at high geographic/genetic risk develop GB polyps, 'extremely low risk' polyps may be managed as 'low risk' and 10–14 mm 'extremely low risk' or '7–14 mm' low risk polyps that decrease in size by ≥ 4 mm require no follow-up. Thin-stalked or pedunculated polyps are 'extremely low risk' and thick-stalked pedunculated polyps are 'low risk'. Sessile polyps are 'low risk' but should receive immediate specialist referral if features suggestive of GB cancer are present. Neither polyp multiplicity nor vascularity impact risk of GB cancer and follow up should be based on morphology alone. [ABSTRACT FROM AUTHOR]

• Outpatient hysteroscopy and outpatient operative Myosure procedures are both well tolerated with a high success rate (99%) and patient satisfaction rate (96%). • There was no association between pre-existing pain and actual pain for outpatient hysteroscopy procedures. • There was no statistical evidence that age, parity, tubal status or menopausal status were associated with higher operative Myosure pain scores. • There was a weak association with anticipated pain scores and actual pain scores for both the diagnostic hysteroscopy and operative Myosure. Abnormal uterine bleeding (AUB) affects women of all ages and is one of the most common reasons for referral to a gynaecological clinic. Operative hysteroscopic procedures allow for a see-and-treat approach to AUB, and these techniques have been shown to be feasible and acceptable in the outpatient setting. To assess if there is an increase in pain scores for women who are undergoing an operative hysteroscopic procedure with Myosure LITE® (Hologic; mechanical hysteroscopic tissue removal system) compared to outpatient diagnostic hysteroscopy alone. A prospective cohort study was performed. All participants attending the outpatient hysteroscopy clinic at Mercy Hospital for Women completed a pre-and post-procedure questionnaire. This included a visual analogue scale (VAS) for any pre-existing pain, anticipated pain, and actual pain experienced during procedure. Factors influencing overall satisfaction and willingness to attend again were also assessed. Data was entered into RedCap® for analysis. A difference in VAS of 10 mm or more was considered clinically significant. An alpha of p < 0.05 was assigned for statistical significance. Between February 2020 and November 2022, 208 women underwent outpatient diagnostic hysteroscopy followed by an operative hysteroscopy with MyoSure®. To allow for standardisation of analgesia, only participants who had a cervical block before their Myosure® procedure were included for analysis (n = 111). There was statistical evidence (t(1 1 1) = 2.36, p = 0.02) of a lower mean VAS pain score for operative Myosure (36.5 mm, 95 % CI: 31.1–41.8 mm) compared to outpatient diagnostic hysteroscopy (44.1 mm, 95 % CI: 39.0–49.2 mm). The mean difference in VAS pain score was estimated as 7.7 mm (95 % CI: 1.2–14.1 mm) lower for Myosure compared to hysteroscopy. Given the threshold for clinical significance was considered as 10 mm difference in VAS, the variance in pain scores is under the likely clinically significant range. There was no significant difference in pain scores for diagnostic hysteroscopy with or without paracervical block (mean difference = 1.42; 95 % CI: −6.35 to 9.20). There was no association between pre-existing pain, and actual pain for hysteroscopy, or Myosure (p = 0.997 and p = 0.065 respectively). The anticipated pain score was weakly associated with actual pain during the operative Myosure procedure (p = 0.02), and with outpatient diagnostic hysteroscopy (p = 0.019). Outpatient hysteroscopy procedures are generally well tolerated. The pain experience with operative Myosure was less than that reported during the diagnostic hysteroscopy by the same patient although this is unlikely of clinical significance. Importantly, Myosure was not more painful than the initial diagnostic procedure, and most patients were satisfied with the outcome and would choose to have the procedure again in an outpatient setting. This is in keeping with other studies which have shown a high degree of patient tolerance and satisfaction with this approach. [ABSTRACT FROM AUTHOR]

Colorectal cancer is the third most common cancer among men and the second among women. In the United States alone, there are 150,000 cases diagnosed each year. Colonoscopy remains the best method for identifying, evaluating, and intervening on patients with precancerous lesions. Multiple guidelines and techniques are available to assist the endoscopist with accurate diagnosis of these lesions. These include the Paris, Narrow-Band Imaging (NBI) International Colorectal Endoscopic (NICE), Japan NBI Expert Team (JNET), Kudo, Hiroshima, and Shudo classifications which utilize techniques such as chromoendoscopy, narrow-band imaging, and endocytoscopy to evaluate pit pattern and surface morphology. Utilization of these tools can help the endoscopist predict the cytology of a colonic lesion and select the most appropriate method for resection while maximizing organ preservation. [ABSTRACT FROM AUTHOR]

Abstract The influence of metabolic dysfunction-associated steatotic liver disease (MASLD) on gallbladder polyp development in both sexes remains elusive. Therefore, to clarify the role of MASLD in gallbladder polyp development, we investigated the longitudinal association between MASLD and gallbladder polyps. In this observational study, we included 5,527 gallbladder polyp-free patients who underwent > 2 health check-ups over > 2 years. Generalized estimation equations were used to analyze associations between MASLD and gallbladder polyp development according to repeated measures at baseline and the most recent stage. Gallbladder polyp development rates in men and women were 7.5% and 5.6% (p

Abstract Background Heterotopic gastric mucosa (HGM) can be located in various parts of the gastrointestinal tract. As a rare anomaly in the small intestine, it can become complicated by intussusception, obstruction, gastrointestinal bleeding, and even peritonitis, leading to death. Case presentation This case report focuses on a 12-year-old Middle Eastern boy who presented with hematochezia and abdominal pain for a couple of days. A tagged Red blood cell (RBC) scan and Technetium scan revealed gastrointestinal bleeding at the lower abdomen, highly suggestive of the diagnosis of Meckel’s diverticulum. Subsequently, exploratory laparotomy revealed contiguous and scattered mucosal lesions with multiple polyps of various sizes in the terminal ileum. Meckel’s diverticulum was absent, and the patient was treated with resection and primary anastomosis. The resected tissue revealed extensive ectopic gastric mucosa and polypoid tissues. The patient recovered uneventfully and was discharged four days after the surgery. The symptoms did not recur within six months after his surgery. Conclusion Our case demonstrated that despite the rarity of multiple polypoid gastric heterotopias in the terminal ileum, it should be considered as one of the differential diagnoses of gastrointestinal tract bleeding.

Background: Sino nasal mass (SNM) is a common clinical entity in the ENT outpatient department. It affects all age groups. SNMs are mainly non-neoplastic inflammatory polyp, benign tumor, and malignant tumor, out of which inflammatory polyp is the most common entity. Radiological investigation plays a major role in SNM. Surgery is the treatment of choice in almost all cases. Functional endoscopic sinus surgery (FESS) is the most commonly employed approach for surgery. Aims and Objectives: The aim of the current study is to analyze the clinicopathological aspects and enumerate the various management strategies of SNMs in patients attending the department of ENT in a tertiary care hospital in the upper Assam region. Materials and Methods: The present study was conducted in Assam Medical College between May 2022 and October 2023. During the period of this prospective observational study, 100 patients presented with SNMs. Results: Total 100 patients were reviewed, out of which 59 patients were male and 41 females. Overall, the most common affected age group was 31–40 years. Seventy-seven cases were non-neoplastic sinonasal polyps, 16 cases were benign tumors and seven were malignant tumors. Sixty-four patients had undergone FESS, 20 patients had endoscopic sinus surgery with or without medial maxillectomy and eight patients had lateral rhinotomy. Malignant cases were managed by radiotherapy and chemoradiation mainly. Conclusion: Sinonasal polyp is a very common entity among all SNMs. Computed tomography scan is the main diagnostic tool. FESS is the most commonly used surgical procedure with less complication.

Small target polyps are prone to missed detection due to their small coverage area and little information. To address this issue, a modified PATM-YOLO polyp detection model based on YOLOv5 is proposed. The model first addresses the issue of missed detection of small polyps by constructing a detection head for identifying small polyps and using an improved Phase-Aware Token Mixing Module(PATM) attention module to increase the network's attention to small polyps and suppress the model's focus on non-polyp regions. Secondly, an improved Adaptively Spatial Feature Fusion(ASFF) module is proposed to fully utilize multi-scale information, enhancing the network's feature richness. Finally, by introducing the Swin Transformer into the network and determining its optimal placement through experiments, the detection accuracy is maximized without affecting the network's performance. After experimental comparison on the constructed dataset and the public dataset SUN, the proposed PATM-YOLO network model alleviated missed detection in dense and small polyp images, and achieved an precision of 91.3 % , which is 8.5 % higher than the baseline YOLOv5 network model. This indicates that the detection performance of this model outperforms other classical target detection networks and the original network. [ABSTRACT FROM AUTHOR]

Background: Heterotopic gastric mucosa (HGM) can be located in various parts of the gastrointestinal tract. As a rare anomaly in the small intestine, it can become complicated by intussusception, obstruction, gastrointestinal bleeding, and even peritonitis, leading to death. Case presentation: This case report focuses on a 12-year-old Middle Eastern boy who presented with hematochezia and abdominal pain for a couple of days. A tagged Red blood cell (RBC) scan and Technetium scan revealed gastrointestinal bleeding at the lower abdomen, highly suggestive of the diagnosis of Meckel's diverticulum. Subsequently, exploratory laparotomy revealed contiguous and scattered mucosal lesions with multiple polyps of various sizes in the terminal ileum. Meckel's diverticulum was absent, and the patient was treated with resection and primary anastomosis. The resected tissue revealed extensive ectopic gastric mucosa and polypoid tissues. The patient recovered uneventfully and was discharged four days after the surgery. The symptoms did not recur within six months after his surgery. Conclusion: Our case demonstrated that despite the rarity of multiple polypoid gastric heterotopias in the terminal ileum, it should be considered as one of the differential diagnoses of gastrointestinal tract bleeding. [ABSTRACT FROM AUTHOR]

Neuronal senescence is a major risk factor for the development of many neurodegenerative disorders. The mechanisms that drive neurons to senescence remain largely elusive; however, dysregulated mitochondrial physiology seems to play a pivotal role in this process. Consequently, strategies aimed to preserve mitochondrial function may hold promise in mitigating neuronal senescence. For example, dietary restriction has shown to reduce senescence, via a mechanism that still remains far from being totally understood, but that could be at least partially mediated by mitochondria. Here, we address the role of mitochondrial inorganic polyphosphate (polyP) in the intersection between neuronal senescence and dietary restriction. PolyP is highly present in mammalian mitochondria; and its regulatory role in mammalian bioenergetics has already been described by us and others. Our data demonstrate that depletion of mitochondrial polyP exacerbates neuronal senescence, independently of whether dietary restriction is present. However, dietary restriction in polyP‐depleted cells activates AMPK, and it restores some components of mitochondrial physiology, even if this is not sufficient to revert increased senescence. The effects of dietary restriction on polyP levels and AMPK activation are conserved in differentiated SH‐SY5Y cells and brain tissue of male mice. Our results identify polyP as an important component in mitochondrial physiology at the intersection of dietary restriction and senescence, and they highlight the importance of the organelle in this intersection. [ABSTRACT FROM AUTHOR]

Simple Summary: The invasive freshwater jellyfish Craspedacusta sowerbii exists as a microscopic polyp stage and a more visible, pelagic jellyfish-like medusa stage. Current methods to collect these polyps are challenging and time consuming, so we developed a more efficient method involving glass and plastic microscope slides. Polyps became established on these slides, confirming the efficacy of our method. Current sampling methods for detecting the presence of the invasive freshwater hydrozoan Craspedacusta sowerbii rely mainly on visual confirmation of the medusa stage. Confirming the presence of the polyp stage is equally important for observing medusae since typical late summer/early fall occurrences or observations of medusae are sporadic though are becoming more frequent. The polyp stage is important as it is the organism's primary stage and is present throughout the year depending on water temperatures. Therefore, sampling methods for the polyp stage are, commonly, the collection of substrates such as rocks, plants, or pieces of wood in a given body of water, and these can be cumbersome to examine. Polyps are also small, transparent, and difficult to see on natural substrates. Based on a preliminary culturing of the polyp stage on glass and plastic microscope slides in the laboratory, we designed a sampling methodology based on submerging four substrate types (glass and plastic microscope slides, Hester-Dendy discs, and small glass Petri dishes) to confirm the presence of C. sowerbii polyps in the field. We tested this method in three lakes in the Illinois–Indiana region (USA). Two of the lakes have recorded sightings of medusae but the third has no record of polyps or medusae. The sampling method we designed was effective in that C. sowerbii polyps were found on both plastic and glass slides. While this method can be sufficient for detection of the polyp stage, it also shows potential for improvement; we highlight abiotic and biotic ecological parameters as significant factors influencing the collection of C. sowerbii polyps to be considered for future methodologies. [ABSTRACT FROM AUTHOR]

Summary: Despite the widespread adoption of nasal endoscopy (NE) in the evaluation of sinonasal disease, its diagnostic potential may still be underutilized. Developments in endoscopic technology have led to significant improvements in video quality and maneuverability. However, there is concern that NE continues to be used primarily for the identification of gross pathology, with relative neglect of more subtle findings such as surface features of inflammation and mucus. With fewer technical limitations to perceive these abnormalities, there is potential to greatly improve the diagnostic value of NE. The reader is herein asked to consider several important visual nuances encountered during NE, with the hope that this engenders an appreciation of the versatility of NE as a diagnostic tool. [ABSTRACT FROM AUTHOR]

The existing literature points towards the presence of robust mitochondrial mechanisms aimed at mitigating protein dyshomeostasis within the organelle. However, the precise molecular composition of these mechanisms remains unclear. Our data show that inorganic polyphosphate (polyP), a polymer wellconserved throughout evolution, is a component of these mechanisms. In mammals, mitochondria exhibit a significant abundance of polyP, and both our research and that of others have already highlighted its potent regulatory effect on bioenergetics. Given the intimate connection between energy metabolism and protein homeostasis, the involvement of polyP in proteostasis has also been demonstrated in several organisms. For example, polyP is a bacterial primordial chaperone, and its role in amyloidogenesis has already been established. Here, using mammalian models, our study reveals that the depletion of mitochondrial polyP leads to increased protein aggregation within the organelle, following stress exposure. Furthermore, mitochondrial polyP is able to bind to proteins, and these proteins differ under control and stress conditions. The depletion of mitochondrial polyP significantly affects the proteome under both control and stress conditions, while also exerting regulatory control over gene expression. Our findings suggest that mitochondrial polyP is a previously unrecognized, and potent component of mitochondrial proteostasis. [ABSTRACT FROM AUTHOR]

Background Hybrid approaches combining endoscopic full-thickness resection (EFTR) with conventional techniques (endoscopic mucosal resection [EMR], endoscopic submucosal dissection [ESD]) have enabled the resection of difficult fibrotic colorectal adenomas exhibiting a "non-lifting" sign, and polyps in difficult positions. We present our cohort treated with either EMR+EFTR or ESD+EFTR as salvage hybrid endoscopic approaches for complex colorectal polyps not amenable to conventional techniques. Methods Retrospective analysis included technical success, histological confirmation of marginfree resection, assessment of adverse events and follow up with histological assessment. All patients underwent follow-up endoscopy at least 6 and 12 months post-resection. Results Fourteen patients underwent hybrid EFTR procedures (11 EMR+EFTR and 3 ESD+EFTR). Technical success was achieved in all cases where the full-thickness resection device (FTRD) was advanced to the site of the resection (100%). In 2 cases, the FTRD system could not be passed through the sigmoid colon because of severe chronic diverticulitis, subsequent fibrosis and stiffness. The mean lesion size in the EMR+EFTR group (41.7 mm; range 20-50 mm) was larger than the ESD+EFTR group (31.7 mm; range 30-35 mm). Six patients (42.9%) were histologically diagnosed with T1 carcinoma. The mean duration of hospitalization was 1.4 days. Follow-up endoscopy was available in all patients and no recurrence was observed with histological confirmation during a mean follow-up period of 15.4 months. Conclusion Hybrid procedures appear to be safe and effective treatments for complex colorectal lesions not amenable to EMR, ESD or EFTR alone, because of the lesion size, positive non-lifting sign, and difficult positions. [ABSTRACT FROM AUTHOR]

We previously reported unusual adenomas with proliferative zones confined to the lower two-thirds of the crypt. The proliferative zones of colorectal adenomas have three patterns: 'lower,' 'superficial' and 'entire'. This study aimed to clarify the characteristics of each adenoma pattern. We investigated 2925 consecutive patients who underwent colonoscopy at our institute. All polyps that were removed were histologically examined using hematoxylin and eosin staining. The location of the proliferative zone was assessed for adenomas. Data were compared using Dunn's and Kruskal–Wallis tests. Colorectal adenomas with 'lower' proliferative zone often appeared similar to hyperplastic polyps (42.8%), and the frequency was significantly higher than that of adenomas with 'superficial' and 'entire' proliferative zones (p < 0.001). The mean sizes of adenomas were 2.4, 3.0 and 3.9 mm for 'lower,' 'superficial' and 'entire' proliferative zones, respectively. A significant gradual increase was observed. Regarding morphology, the proportion of type 0–I in adenomas with an 'entire' proliferative zone was significantly higher than that in adenomas with 'superficial' proliferative zone (p < 0.001). While colorectal adenomas develop and increase in size, the proliferative zone appears to shift upward and become scattered. [ABSTRACT FROM AUTHOR]

Background: Colon capsule endoscopy (CCE) has gained momentum as an alternative modality for the investigation of the lower gastrointestinal tract. Of the few challenges that remain, the comparison and – eventually – matching of polyps at different timestamps leads to the potential for double reporting and can contribute to false-positive findings and inaccuracies. With the impending artificial intelligence integration, the risk of double reporting the same polyp due to the lack of information on spatial orientation underscores the necessity for establishing criteria for polyp matching. Objectives: This RAND/University of California, Los Angeles (modified Delphi) process aims to identify the key factors or components used to match polyps within a CCE video. This involves exploring the attributes of each factor to create comprehensive polyp-matching criteria based on international expert consensus. Design: A systematic qualitative study using surveys. Methods: A panel of 11 international CCE experts convened to assess a survey comprised of 60 statements. Participants anonymously rated statement appropriateness on a 1–9 scale (1–3: inappropriate, 4–6: uncertain and 7–9: appropriate). Following a virtual group discussion of the Round 1 results, a Round 2 survey was developed and completed before the final analysis. Results: The factors that were agreed to be essential for polyp matching include (1) timestamp, (2) polyp localization, (3) polyp vascular pattern, (4) polyp size, (5) time interval of the polyp appearance between the green and yellow camera, (6) surrounding tissue, (7) polyp morphology and (8) polyp surface and contour. When five or more factors are satisfied, it was agreed that the comparing polyps are likely the same polyp. Conclusion: This study has established the first complete criteria for polyp matching in CCE. While it might not provide a definitive solution for matching difficult, small and common polyps, these criteria serve as a framework to guide and facilitate the process of polyp-matching. Plain language summary: Creating criteria and standards for matching polyps (abnormal growth in the bowels) on colon capsule video analysis: an international expert agreement using the RAND (modified Delphi process) process Background: Doctors often use colon capsule endoscopy (CCE), a high-tech capsule with two cameras, to record and check for diseases in the small and large bowels as the capsule travels through the intestines. One of the most common conditions in the large bowel is polyps, which are abnormal growths in the lining of the bowel. Comparing and matching polyps in the same video from the capsule can be tricky as they look very similar, leading to the possibility of incorrectly reporting the same polyp twice or more. This can lead to wrong results and inaccuracies. The literature did not have any criteria or standards for matching polyps in CCE before. Aim: Using the RAND/UCLA (modified Delphi) process, this study aims to identify the key factors or components used to match polyps within a CCE video. The goal is to explore each factor and create complete criteria for polyp matching based on the agreement from international experts. Method: A group of 11 international CCE experts came together to evaluate a survey with 60 statements. They anonymously rated each statement on a scale from 1 to 9 (1-3: inappropriate, 4-6: uncertain, and 7-9: appropriate). After discussing the Round 1 results virtually, a Round 2 survey with the same but revised questions was created and completed before the final analysis of their agreement. Results: The main factors for matching polyps are 1) the timing when the polyp was seen, 2) where it is in the bowel, 3) its blood vessel pattern, 4) size, 5) the timing of its appearance between cameras, 6) surrounding tissue features, 7) its shape, and 8) surface features. If five or more of these factors match, the compared polyps are likely the same. Conclusion: This study establishes the first complete criteria for matching polyps in CCE. While it may not provide a definitive solution for matching challenging and small polyps, these criteria serve as a guide to help and make the process of polyp matching easier. [ABSTRACT FROM AUTHOR]

An endometrial polyp is most commonly a benign, localized proliferation of the glands and the endometrial stroma, covered with epithelium and protruding above the level of the mucosa. These polyps are most often diagnosed during investigation into the causes of irregular menstrual bleeding or infertility. It is produced in the highest concentration during the secretory phase of the endometrial cycle. The level of glycodelin reaches its peak 12 days after ovulation. The aim of this paper was to determine the changes in the immunohistochemical expression of glycodelin at the level of the endometrium and in the tissue of the polyp, before and after hysteroscopic polypectomy, in infertile female patients with an endometrial polyp, and in the endometrial tissue of female patients without an endometrial polyp. The study included 82 infertile female patients. The infertile patients were divided into two groups. The first was the experimental group which included 56 infertile female patients who had an endometrial polyp. The second group was the control group, composed of 26 infertile female patients who did not have an endometrial polyp. The results obtained primarily indicate the existence of changes in the immunohistochemical expression of the cytokine glycodelin in the female patients from both the experimental and the control group, not only prior to but also after hysteroscopy. A larger number of patients who have an endometrial polyp show a lack of glycodelin expression, more pronouncedly so in the bioptate of the endometrium than in the endometrial polyp. [ABSTRACT FROM AUTHOR]

Aim: The prevalence of Helicobacter pylori (H. pylori) varies among populations as well as among the world’s populations. In this study, we aimed to investigate the frequency and effects of H. pylori in our patients living in the Eastern Anatolia Region. Materials and Methods: This retrospective study was conducted with 2.062 patients living in the Eastern Anatolia Region between 2021 and 2022 and applying to the endoscopy unit for gastroscopy. The demographic characteristics, gastroscopy findings, and histopathological characteristics of the materials taken during the endoscopy of our patients who applied to us for various indications were recorded in the hospital database. Results: The average age of the patients included in our study was 45.9±16.4 years. 1.100 of these patients were women and 962 were men. 308 of the patients had gastric mucosal atrophy, 224 had intestinal metaplasia, and 1.151 were H. pylori positive. Of the H. pylori-positive patients, 214 had bulbar ulcers and 48 had stomach ulcers. Intestinal metaplasia and gastric mucosal atrophy were statistically significantly associated with the age of the patients. Conclusion: H. pylori infection causes many changes in the stomach, both endoscopically and histopathologically. However, the main reason for this change is host genetics and the virulence of H. pylori. [ABSTRACT FROM AUTHOR]

Background: Sino nasal mass (SNM) is a common clinical entity in the ENT outpatient department. It affects all age groups. SNMs are mainly non-neoplastic inflammatory polyp, benign tumor, and malignant tumor, out of which inflammatory polyp is the most common entity. Radiological investigation plays a major role in SNM. Surgery is the treatment of choice in almost all cases. Functional endoscopic sinus surgery (FESS) is the most commonly employed approach for surgery. Aims and Objectives: The aim of the current study is to analyze the clinicopathological aspects and enumerate the various management strategies of SNMs in patients attending the department of ENT in a tertiary care hospital in the upper Assam region. Materials and Methods: The present study was conducted in Assam Medical College between May 2022 and October 2023. During the period of this prospective observational study, 100 patients presented with SNMs. Results: Total 100 patients were reviewed, out of which 59 patients were male and 41 females. Overall, the most common affected age group was 31-40 years. Seventy-seven cases were non-neoplastic sinonasal polyps, 16 cases were benign tumors and seven were malignant tumors. Sixty-four patients had undergone FESS, 20 patients had endoscopic sinus surgery with or without medial maxillectomy and eight patients had lateral rhinotomy. Malignant cases were managed by radiotherapy and chemoradiation mainly. Conclusion: Sinonasal polyp is a very common entity among all SNMs. Computed tomography scan is the main diagnostic tool. FESS is the most commonly used surgical procedure with less complication. [ABSTRACT FROM AUTHOR]

The patients are often elderly, presenting the symptoms, and fully recognizing the disease is difficult. It is sometimes confused with inflammatory bowel disease. Within the scope of this research, we aimed to elucidate the frequency of colon diverticulum in patients who underwent lower gastrointestinal endoscopy in our clinic. Demographic data and its relationship with the patient's height-weight-body mass index will also be evaluated. The medical files of 200 patients aged 18–90 years who underwent lower gastrointestinal system endoscopy in our institution have been retrospectively analyzed. The demographic details, age, gender, and results of endoscopy findings have been investigated with respect to detecting colon diverticulum. The presence of diverticula was observed in 7% of the patients (n=14), external hemorrhoids in 1% (n=2), internal hemorrhoids in 28% (n=56), and polyps in 21.5% (n=43). A statistically significant relationship was observed between the genders of the patients in terms of the presence of polyps (p<0.05). The distribution of clinical findings of the patients according to age and body mass index (BMI) did not reveal any statistically significant relationship. The prevalence of diverticulitis is increasing gradually with the aging population. We believe interval lower gastrointestinal system endoscopy remains a significant tool, especially after an acute attack, particularly after complicated diverticulitis, to rule out malignancy or advanced adenomata at the target site and the rest of the colon. [ABSTRACT FROM AUTHOR]

The early detection of colorectal polyps is crucial for the reduction of mortality rates. However, manually identifying polyps is time-consuming and expensive, increasing the risk of missing them. Our paper aims to address this issue by presenting an automated segmentation approach for colorectal polyps. This paper proposes a method that combines a skip connection with hybrid attention guidance (AG) using attention guidance (AG) and residual path frameworks to identify salient features. Furthermore, we augment test samples using original, horizontal flip, and vertical flip transformations to enhance model robustness through Test Time Augmentation (TTA). The model was trained with Kvasir-seg samples and evaluated on Kvasir-seg and CVC-ClinicDB datasets to gauge generalizability. A significant accuracy (0.9546), a Dice Similarity Coefficient (DSC) of 0.8557, a Cross-section over Union (IoU) of 0.8824, a Recall (0.8221), a Precision (0.8922), an area under Receiver Operating Characteristics (ROC-AUC) of 0.9454, and an area under Precision-Recall (AUC-PR) of 0.8717 were achieved without TTA. Through TTA integration, accuracy (0.9993), DSC (0.8663), IoU (0.8277), Recall (0.8060), Precision (0.9364), and ROC-AUC (0.9587) have been improved. A comparison of our framework with state-of-the-art models demonstrated its effectiveness and segmentation capabilities. Additionally, the proposed model contains only 0.47 million parameters and a weight size of 6.71 MB, illustrating its potential for clinical diagnostics. A computer-aided diagnosis (CAD) system improves patient outcomes by detecting colorectal polyps early and improving segmentation accuracy. [ABSTRACT FROM AUTHOR]

IntroductionArtificial intelligence is already widely utilized in gastroenterology. This study aims to comprehensively evaluate the research hotspots and development trends within the field of AI in gastroenterology by employing bibliometric techniques to scrutinize geographical distribution, authorship, affiliated institutions, keyword usage, references, and other pertinent data contained within relevant publications.MethodsThis investigation compiled all pertinent publications related to artificial intelligence in the context of gastrointestinal polyps and digestive endoscopy from 2003 to 2023 within the Web of Science Core Collection database. Furthermore, the study harnessed the tools CiteSpace, VOSviewer, GraphPad Prism and Scimago Graphica for visual data analysis. The study retrieved a total of 2,394 documents in the field of AI in digestive endoscopy and 628 documents specifically related to AI in digestive tract polyps.ResultsThe United States and China are the primary contributors to research in both fields. Since 2019, studies on AI for digestive tract polyps have constituted approximately 25% of the total AI digestive endoscopy studies annually. Six of the top 10 most-cited studies in AI digestive endoscopy also rank among the top 10 most-cited studies in AI for gastrointestinal polyps. Additionally, the number of studies on AI-assisted polyp segmentation is growing the fastest, with significant increases in AI-assisted polyp diagnosis and real-time systems beginning after 2020.DiscussionThe application of AI in gastroenterology has garnered increasing attention. As theoretical advancements in AI for gastroenterology have progressed, real-time diagnosis and detection of gastrointestinal diseases have become feasible in recent years, highlighting the promising potential of AI in this field.

Patients with vocal cord polyps commonly present with symptoms of hoarseness. Although rare, large polyps can cause shortness of breath and stridor and should be included in the differential for patients with airway obstruction. Dysphonia or hoarseness can be a symptom of underlying disease, such as head and neck cancer. This case illustrates the importance of prompt and accurate diagnosis in a patient with persistent symptoms and a history of smoking. Obtaining a laryngoscopy is crucial to appropriately evaluate the larynx. Proper visualization of the laryngeal structures will help direct patient care toward further diagnostic imaging and medical or surgical intervention if indicated. [ABSTRACT FROM AUTHOR]

Abstract The early detection of colorectal polyps is crucial for the reduction of mortality rates. However, manually identifying polyps is time-consuming and expensive, increasing the risk of missing them. Our paper aims to address this issue by presenting an automated segmentation approach for colorectal polyps. This paper proposes a method that combines a skip connection with hybrid attention guidance (AG) using attention guidance (AG) and residual path frameworks to identify salient features. Furthermore, we augment test samples using original, horizontal flip, and vertical flip transformations to enhance model robustness through Test Time Augmentation (TTA). The model was trained with Kvasir-seg samples and evaluated on Kvasir-seg and CVC-ClinicDB datasets to gauge generalizability. A significant accuracy (0.9546), a Dice Similarity Coefficient (DSC) of 0.8557, a Cross-section over Union (IoU) of 0.8824, a Recall (0.8221), a Precision (0.8922), an area under Receiver Operating Characteristics (ROC-AUC) of 0.9454, and an area under Precision-Recall (AUC-PR) of 0.8717 were achieved without TTA. Through TTA integration, accuracy (0.9993), DSC (0.8663), IoU (0.8277), Recall (0.8060), Precision (0.9364), and ROC-AUC (0.9587) have been improved. A comparison of our framework with state-of-the-art models demonstrated its effectiveness and segmentation capabilities. Additionally, the proposed model contains only 0.47 million parameters and a weight size of 6.71 MB, illustrating its potential for clinical diagnostics. A computer-aided diagnosis (CAD) system improves patient outcomes by detecting colorectal polyps early and improving segmentation accuracy.

Objectives: Detailed superiority of CAD EYE (Fujifilm, Tokyo, Japan), an artificial intelligence for polyp detection/diagnosis, compared to endoscopists is not well examined. We examined endoscopist's ability using movie sets of colorectal lesions which were detected and diagnosed by CAD EYE accurately. Methods: Consecutive lesions of 10 mm were examined live by CAD EYE from March-June 2022 in our institution. Short unique movie sets of each lesion with and without CAD EYE were recorded simultaneously using two recorders for detection under white light imaging (WLI) and linked color imaging (LCI) and diagnosis under blue laser/light imaging (BLI). Excluding inappropriate movies, 100 lesions detected and diagnosed with CAD EYE accurately were evaluated. Movies without CAD EYE were evaluated first by three trainees and three experts. Subsequently, movies with CAD EYE were examined. The rates of accurate detection and diagnosis were evaluated for both movie sets. Results: Among 100 lesions (mean size: 4.7±2.6 mm; 67 neoplastic/33 hyperplastic), mean accurate detection rates of movies without or with CAD EYE were 78.7%/96.7% under WLI (p

Abstract Background Peutz–Jeghers syndrome is a rare hereditary condition characterized by gastrointestinal polyps and pigmented oral lesions. The case contributes to a deeper understanding of Peutz–Jeghers syndrome and underscores the significance of interdisciplinary collaboration for accurate diagnosis and tailored therapeutic strategies. Case description We present a case of a 15-year-old Afghan female patient with multiple polyps throughout the gastrointestinal tract and mucocutaneous pigmentation. Despite previous medical visits and colonoscopies, her symptoms persisted. A multidisciplinary team discussed the case and recommended further investigations and interventions. A polypectomy was performed, confirming the presence of hamartomatous polyps. The patient was diagnosed with Peutz–Jeghers syndrome, but during the course of treatment she went through complications and was managed surgically as well. Conclusion Timely polyp removal and lifelong surveillance are crucial in managing Peutz–Jeghers syndrome. Further research and genetic analysis are needed to improve understanding and management of this rare disorder.

The clinical effect of praziquantel on chronic intestinal schistosomiasis in the literature is lacking. We report a patient who presented with 3 years of non-specific abdominal pain and underwent colonoscopy, which revealed colon polyps that, on biopsy, were confirmed to be due to Schistosoma mansoni. The patient was given a single dose of praziquantel, and his abdominal symptoms disappeared within 24 h. Patients with abdominal pain in the setting of chronic Schistosoma infection should be given praziquantel and assess response clinically.

Background: Accurate measurement of polyps size is crucial in predicting malignancy, planning relevant intervention strategies and surveillance schedules. Endoscopists' visual estimations can lack precision. This study builds on our prior research, with the aim to evaluate a recently developed quantitative method to measure the polyp size and location accurately during a simulated endoscopy session. Methods: The quantitative method merges information about endoscopic positions obtained from an electromagnetic tracking sensor, with corresponding points on the images of the segmented polyp border. This yields real-scale 3D coordinates of the border of the polyp. By utilising the sensor, positions of any anatomical landmarks are attainable, enabling the estimation of a polyp's location relative to them. To verify the method's reliability and accuracy, simulated endoscopies were conducted in pig stomachs, where polyps were artificially created and assessed in a test–retest manner. The polyp measurements were subsequently compared against clipper measurements. Results: The average size of the fifteen polyps evaluated was approximately 12 ± 4.3 mm, ranging from 5 to 20 mm. The test–retest reliability, measured by the Intraclass Correlation Coefficient (ICC) for polyp size estimation, demonstrated an absolute agreement of 0.991 (95% CI 0.973–0.997, p < 0.05). Bland & Altman analysis revealed a mean estimation difference of − 0.17 mm (− 2.03%) for polyp size and, a mean difference of − 0.4 mm (− 0.21%) for polyp location. Both differences were statistically non-significant (p > 0.05). When comparing the proposed method with calliper measurements, the Bland & Altman plots showed 95% of size estimation differences between − 1.4 and 1.8 mm (− 13 to 17.4%) which was not significant (p > 0.05). Conclusions: The proposed method of measurements of polyp size and location was found to be highly accurate, offering great potential for clinical implementation to improve polyp assessment. This level of performance represents a notable improvement over visual estimation technique used in clinical practice. [ABSTRACT FROM AUTHOR]

Background and Aim: Although studies have shown that the quality of bowel preparation with low‐residue diet (LRD) is as effective as that of clear fluid diet (CLD), there is currently no consensus on how long an LRD should last. The aim of this study was to compare a 1‐day versus 3‐day LRD on bowel preparation before colonoscopy. Methods: A systematic review search was conducted in MEDLINE/PubMed, EMBASE, Web of Science, and Cochrane database from inception to April 2023. We identified randomized controlled trials (RCTs) that compared 1‐day with 3‐day LRD bowel cleansing regiments for patients undergoing colonoscopy. The rate of adequate bowel preparation, polyp detection rate, adenoma detection rate, tolerability, willingness to repeat preparation, and adverse events were estimated using odds ratios (OR) and 95% confidence interval (CI). We also performed meta‐analysis to identify risk factors and predictors of inadequate preparation. Results: Four studies published between 2019 and 2023 with 1927 participants were included. The present meta‐analysis suggested that 1‐day LRD was comparable with 3‐day LRD for adequate bowel preparation (OR 0.89; 95% CI, 0.65–1.21; P = 0.45; I2 = 0%; P = 0.52). The polyp detection rate (OR 0.94; 95% CI, 0.77–1.14; P = 0.52; I2 = 23%; P = 0.27) and adenoma detection rate (OR 0.87; 95% CI, 0.71–1.08; P = 0.21; I2 = 0%; P = 0.52) were similar between the groups. There were significantly higher odds of tolerability in patients consuming 1‐day LRD compared with 3‐day LRD (OR 1.64; 95% CI, 1.13–2.39; P < 0.01; I2 = 47%; P = 0.15). In addition, constipation was identified as the independent predictor of inadequate preparation (OR 1.98; 95% CI, 1.27–3.11; P < 0.01; I2 = 0%; P = 0.46). Conclusion: The present study demonstrated that a 1‐day LRD was as effective as a 3‐day CLD in the quality of bowel preparation before colonoscopy and significantly improved tolerability of patients. In addition, constipation is an independent risk factor of poor bowel preparation, and the duration of LRD in patients with constipation still needs further clinical trials. [ABSTRACT FROM AUTHOR]

Introduction. : Microscopic colitis is generally identified on random colon biopsies performed for chronic diarrhea, but rarely incidental polyps have histologic features of microscopic colitis. We compared patients with polypoid microscopic colitis to control patients with conventional polyps to determine the implications of polypoid microscopic colitis. Methods. : Medical records were searched for patients without prior or concurrent microscopic colitis who were found to have polypoid microscopic colitis. For each patient with polypoid microscopic colitis, one patient with conventional polyps was selected as a control. We reviewed the histologic features of each polypoid microscopic colitis specimen, and evaluated endoscopic and clinical findings for polypoid microscopic colitis patients and controls. Results. : Twenty-six patients with polypoid microscopic colitis were identified with histologic features of collagenous colitis in 8 patients (31%) and lymphocytic colitis in 18 patients (69%). Polypoid microscopic colitis was unifocal in 14 patients (54%) and multifocal in 12 patients (46%). Patients with polypoid microscopic colitis were older than control patients (median age = 60 years vs 66 years, P =.04). On follow-up 7 patients with polypoid microscopic colitis (33%) developed chronic diarrhea compared to 3 (12%) controls (P =.16). Of patients with follow-up biopsies, 1 patient with polypoid microscopic colitis (13%) and no control patients developed microscopic colitis (P = 1). Conclusions. : Polypoid microscopic colitis may be identified in asymptomatic patients and most patients do not develop chronic diarrhea, but some patients with polypoid microscopic colitis develop diarrhea (33% vs 12% in controls) or conventional microscopic colitis on follow-up. Thus pathologists should distinguish polypoid microscopic colitis from conventional microscopic colitis but may inform clinicians of the uncertain association with chronic diarrhea to guide decisions regarding follow-up. [ABSTRACT FROM AUTHOR]

Objective: To determine the quality of colonoscopy in terms of adenoma detection rate in the existing local settings. Study Design: Cross-sectional study. Setting: Department of Gastroenterology, Liaquat National Hospital, Karachi, Pakistan. Period: February 2022 to August 2022. Methods: We analyzed patients having age 18 years or older, of any gender, and who had colonoscopy indications and were required to have a screening colonoscopy for diagnostic purposes. The number of procedures with at least one polyp or adenoma was classified as the polyp detection rate (PDR) and adenoma detection rate (ADR). Result: Total 210 patients were enrolled into the study with median age of 41.5 (29.8-56.3) years and majority were males (n=46, 69.5%). The most frequent indication for colonoscopy was constipation (n=72, 34.3%) followed by bleeding (n=78, 37.1%), chronic diarrhea (n=36, 17.1%), both constipation and diarrhea (n=21, 10%) and altered bowel habits (n=3, 1.4%). PDR and ADR were 16.2% (n=34) and 10% (n=21) respectively. Age was significantly higher among patients who were found to have polyp (p<0.001) and adenomas (p<0.001). Frequency of polyps (p=0.010) and adenomas (p=0.007) were significantly higher in male patients. Conclusion: The current research discovered a low rate of adenoma detection in people receiving colorectal cancer screening, and it did not meet the quality benchmarks that have been associated with higher rates of early diagnosis and cancer prevention. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Individuals with familial adenomatous polyposis (FAP) have an almost 20% lifetime risk of duodenal adenocarcinoma, currently the leading cause of death in FAP. The Spigelman staging system provides guidance on the surveillance intervals and timing of prophylactic surgery. Still, its accuracy in predicting duodenal and papillary cancer development has not been systematically evaluated. We investigated the sensitivity and cancer risk of the Spigelman stages. METHODS: We performed a systematic review on PubMed, MEDLINE, EMBASE, and Cochrane and used a randomeffects model to pool effect sizes. RESULTS: After removing duplicate entries, we screened 1,170 records and included 27 studies for quantitative analysis. Once duodenal polyposis reaches Spigelman stage IV, the risk of duodenal and papillary cancers increased to 25% (95% confidence interval [CI] 12%-45%). However, the sensitivity of Spigelman stage IV for these cancers was low (51%, 95% CI 42%-60%), especially for papillary adenocarcinoma (39%, 95% CI 16%-68%). We investigated the reasons behind these low values and observed that duodenal cancer risk factors included polyps >10 mm, polyp count >20, and polyps with high-grade dysplasia. Risk factors associated with papillary cancer included a papilla with high-grade dysplasia or >10 mm. The evidence on other risk factors was inconclusive. DISCUSSION: The current Spigelman staging systemhad a low sensitivity for duodenal and papillary adenocarcinomas. Two Spigelman variables (duodenal villous histology and polyp count) and the lack of papilla-specific variables likely contributed to the low sensitivity values for duodenal and papillary cancers, respectively. While clinicians may be familiar with its current form, there is an urgent need to update it. [ABSTRACT FROM AUTHOR]

Gallbladders are one of the most commonly encountered specimens in routine histopathology. While the usual diagnoses of cholelithiasis and cholecystitis are relatively straightforward, the evaluation of neoplastic changes in the gallbladder can be challenging. Non-invasive neoplasia in the gallbladder can be broadly categorised into flat or non-tumoral dysplasia and tumoral dysplasia, the latter mainly incorporating intracholecystic papillary neoplasms, akin to lesions seen within the bile ducts and pancreas. Flat dysplasia can be particularly difficult to diagnose due to morphological overlaps with reactive atypia, compounded by the common presence of inflammatory changes in cholecystectomy specimens. Tumoral dysplasia, while more easily recognisable, can be problematic due to the different, clinically relevant subtypes that exist. These display variable associations with invasive malignancy and the morphological differences between these lesions can be subtle. This review provides an overview of the key features of flat and tumoral dysplasia in the gallbladder, an approach to handling such cases, and some insights into the main diagnostic challenges that may be faced by general histopathologists when a neoplastic diagnosis is being considered. [ABSTRACT FROM AUTHOR]

Background: Peutz–Jeghers syndrome is a rare hereditary condition characterized by gastrointestinal polyps and pigmented oral lesions. The case contributes to a deeper understanding of Peutz–Jeghers syndrome and underscores the significance of interdisciplinary collaboration for accurate diagnosis and tailored therapeutic strategies. Case description: We present a case of a 15-year-old Afghan female patient with multiple polyps throughout the gastrointestinal tract and mucocutaneous pigmentation. Despite previous medical visits and colonoscopies, her symptoms persisted. A multidisciplinary team discussed the case and recommended further investigations and interventions. A polypectomy was performed, confirming the presence of hamartomatous polyps. The patient was diagnosed with Peutz–Jeghers syndrome, but during the course of treatment she went through complications and was managed surgically as well. Conclusion: Timely polyp removal and lifelong surveillance are crucial in managing Peutz–Jeghers syndrome. Further research and genetic analysis are needed to improve understanding and management of this rare disorder. [ABSTRACT FROM AUTHOR]

The life cycle of the moon jellyfish Aurelia coerulea consists of sessile polyp and free-swimming jellyfish stages. Strobilation is a polyp-to-jellyfish transition comprising sequential segment formation (segmentation), subsequent morphogenesis into ephyrae (young jellyfish), and detachment of the ephyrae. Cell proliferation is involved in metamorphosis in various animals. In the present study, we examined the relationship between cell proliferation and strobilation in A. coerulea. To visualize cell proliferation at various stages of strobilation, 5-bromo-2′-deoxyuridine labeling experiments were conducted, in which cell proliferation was distributed in the segments and prospective regions of the next segment during segmentation. Cell proliferation in segments continues during ephyra morphogenesis. Hydroxyurea, a cell-cycle inhibitor, was administered to investigate cell proliferation in animals at different stages of strobilation. In this study, hydroxyurea interrupted the initiation of strobilation, segmentation, and ephyra morphogenesis, but not ephyra detachment. This suggests that cell proliferation plays a crucial role in generating a new segment and constructing the ephyra body. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Polyp size determination plays an important role in endoscopic decision making and follow-up determination.However, there is a lack of knowledge of endoscopist accuracy for polyp sizing and efficacy of available tools for sizemeasurement.Our aimwas to compare the accuracy of visual assessment, snare, forceps, and virtual scale endoscope (VSE) in estimating polyp size among a diverse group of endoscopists. METHODS: We conducted a prospective video-based study. One hundred twenty polyps measured and recorded along with all available measurement tools were randomized to visual assessment, snare, forceps, or VSE group. Eleven endoscopists conducted video-based measurement using the randomized measurement tool. Primary outcome was relative accuracy in polyp size measurement compared with caliper measurement immediately postresection. RESULTS: One thousand three hundred twenty measurements were performed. VSE had statistically significantly higher relative accuracy when compared to forceps (79.3 vs 71.3%; P < 0.0001). Forceps had statistically significantly higher relative accuracy when compared to visual assessment (71.3 vs 63.6%; P 5 0.0036). There was no statistically significant difference when comparing visual assessment and snare-based measurements (63.6 vs 62.8%; P 5 0.797). Overall, 21.5% of polyps >5 mm were misclassified as £5 mm and 17.3% of polyps ‡10 mm were misclassified as <10 mm. VSE had the lowest percentage of polyps >5 mm misclassified as £5 mm (2.6%), polyps £5 mm misclassified as >5 mm (5.1%), and polyps <10 mm misclassified as ‡10 mm (1.7%). DISCUSSION: Visual size estimation of polyps is inaccurate independently of training level, sex, and specialty. Size measurement accuracy can be improved using forceps and yields the highest relative accuracy when an adaptive scale technology is used. [ABSTRACT FROM AUTHOR]

Background: In the field of otolaryngology, a diverse array of inflammatory, non-neoplastic, and neoplastic growths affecting the nasal cavity, paranasal sinuses, and nasopharynx are frequently encountered across all age groups. This investigation was initiated to document the histopathological characteristics of nasal lesions, their categorization, and the proportional distribution of these lesions concerning age and gender within our clinical setting. Materials and Methods: A retrospective analysis encompassing 78 cases was conducted at an Indian tertiary care level hospital. Patients ranging from 1 to 80 years of age were included in the study cohort. Histopathological analysis was performed on formalin-fixed, paraffin-embedded tissue sections stained with hematoxylin and eosin. The histopathological diagnoses were correlated with pertinent clinical observations and investigative findings. Results: Of the total 78 cases examined, 57 were non-neoplastic, while 21 were neoplastic. Among non-neoplastic lesions, polyps were the most prevalent, followed by fungal infections. Within the neoplastic category, 15 lesions were benign, while six were malignant. Inflammatory polyps constituted the most frequent non-neoplastic lesion, inverted papilloma emerged as the predominant benign lesion, and sinonasal carcinoma was identified as the most prevalent malignant lesion. Conclusion: Histopathological examination stands as a straightforward, dependable, and cost-effective diagnostic modality for identifying various lesions affecting the nasal cavity, paranasal sinuses, and nasopharynx. [ABSTRACT FROM AUTHOR]

Laryngeal granuloma, vocal process granuloma, or post-intubation granuloma are benign, inflammatory lesions of the arytenoid cartilage vocal process. The etiology of laryngeal granulomas is multifactorial, such as chronic irritation due to endotracheal intubation, vocal cord injury or trauma, and gastroesophageal reflux disease. They can arise postoperatively after mucosal injury due to orotracheal intubation. Clinical manifestations include voice change and dyspnea, which may start one to four months after extubation and may rarely lead to asphyxia. We presented a case of death due to glottic granuloma occurring after a surgical procedure to remove a laryngeal polyp attributed to previous laryngeal injuries by multiple intubations.

The existing literature points towards the presence of robust mitochondrial mechanisms aimed at mitigating protein dyshomeostasis within the organelle. However, the precise molecular composition of these mechanisms remains unclear. Our data show that inorganic polyphosphate (polyP), a polymer well-conserved throughout evolution, is a component of these mechanisms. In mammals, mitochondria exhibit a significant abundance of polyP, and both our research and that of others have already highlighted its potent regulatory effect on bioenergetics. Given the intimate connection between energy metabolism and protein homeostasis, the involvement of polyP in proteostasis has also been demonstrated in several organisms. For example, polyP is a bacterial primordial chaperone, and its role in amyloidogenesis has already been established. Here, using mammalian models, our study reveals that the depletion of mitochondrial polyP leads to increased protein aggregation within the organelle, following stress exposure. Furthermore, mitochondrial polyP is able to bind to proteins, and these proteins differ under control and stress conditions. The depletion of mitochondrial polyP significantly affects the proteome under both control and stress conditions, while also exerting regulatory control over gene expression. Our findings suggest that mitochondrial polyP is a previously unrecognized, and potent component of mitochondrial proteostasis.

Abstract Background In polypectomy with mechanical hysteroscopic morcellators, the tissue removal procedure continues until no polyp tissue remains. The decision that the polypoid tissues were removed completely is made based on visual evaluation. In a situation where the polyp tissue was visually completely removed and no doubt that the polyp has been completely removed, short spindle-like tissue fragments on the polyp floor continue in most patients. There are no studies in the literature on whether visual evaluation provides adequate information at the cellular level in many patients in whom polypoid tissues have been determined to be completely removed. The aim of the present study was to analyze the pathological results of the curettage procedure, which was applied following the completion of polyp removal with operative hysteroscopy, and to evaluate whether there was residual polyp tissue in the short spindle-like tissue fragments that the mechanical hysteroscopic morcellator could not remove. The secondary aims of this study were to compare conventional loop resection hysteroscopy with hysteroscopic morcellation for the removal of endometrial polyps in terms of hemoglobin/hematocrit changes, polypectomy time and the amount of medium deficit. Methods A total of 70 patients with a single pedunculate polypoid image of 1.5-2 cm, which was primarily visualized by office hysteroscopy, were included in the study. Patients who had undergone hysteroscopic polypectomy were divided into two groups according to the surgical device used: the morcellator group (n = 35, Group M) and the resectoscope group (n = 35, Group R). The histopathological results of hysteroscopic specimens and curettage materials of patients who had undergone curettage at the end of operative hysteroscopy were evaluated. In addition, the postoperative 24th hour Hb/HCT decrease amounts in percentage, the polypectomy time which was measured from the start of morcellation, and deficit differences were compared between groups. Results In total, 7 patients in the morcellator group had residual polyp tissue detected in the full curettage material. The blood loss was lower in the morcellator group than in the resectoscope group (M, R; (-0.07 ± 0.08), (-0,11 ± 0.06), (p