General Aspects of Primary Cancer Prevention.

BACKGROUND: Cancer is the second leading cause of death worldwide next to cardiovascular diseases. Despite the advancement in screening, early diagnosis, and development in treatment technology in last several decades, cancer incidence overall, particularly that of gastrointestinal (GI) cancers, is far from being controlled, and is expected to increase worldwide. SUMMARY: Although numerous preclinical and population-based clinical studies have already made important progress in restraining the overall cancer incidence and mortality, the full potential of preventive strategy is still far from being realized, and remains at an early stage. There are several major challenges regarding this issue, and one of the crucial challenges is to maintain the balance between risks and benefits. As a result of past investments, primary prevention nowadays include the integration of various activities such as lifestyle changes to reduce risk, screening to detect early lesions, vaccines and preventive therapies aimed to actively interrupt the carcinogenic pathway. Long-term aspirin use seems to have the largest potential effect on the general population on cancer incidence and mortality overall, especially GI cancers. Helicobacter pylori eradication reduces the risk for gastric cancer and is advocated regardless of the symptoms and stage of disease. Metformin and statins are promising in cancer prevention in patients with type 2 diabetes. Vitamin D supplementation is promising in the prevention of colorectal adenoma recurrence. Key Message: However, additional studies are warranted to establish the potential of various agents and to identify more specific and highly targeted new agents for chemoprevention in digestive oncology.

Apple pectin-derived oligosaccharides produce carbon dioxide radical anion in Fenton reaction and prevent growth of Escherichia coli and Staphylococcus aureus.

Pectin is the main soluble fiber in apples or citruses. It may be fermented by gut microbiota to metabolites showing local intestinal and systemic effects. A wide range of beneficial effects of dietary pectin includes impacts on the redox milieu and microbiota profile. We prepared pectin-derived oligosaccharides (apple (APDO) and citrus) and polygalacturonic acid-derived oligosaccharides, using alkaline hydrolysis by hydrogen peroxide, and analyzed them by Fourier Transform Infrared spectrometry. Furthermore, we analyzed the effects of pectin-derived oligosaccharides on hydroxyl radical (HO)-generating Fenton reaction using electron paramagnetic resonance spin-trapping spectroscopy, and the effects on the growth of Escherichia coli and Staphylococcus aureus in the presence of dietary-relevant HO-generating system (iron+ascorbate). The oligosaccharides react with HO radical to produce carbon dioxide radical anion (CO2-). A comparative analysis showed that APDO has the most prominent bacteriostatic effect. This might be at least partially related to the higher capacity of APDO to produce CO2-, which specifically targets proteins and appears to have a longer lifetime and larger diffusion radius in biological systems compared to HO.

[Cameron lesion: an unusual cause of anemia].

INTRODUCTION: Cameron lesions are linear gastric ulcers or erosions positioned on the crests of mucosal folds at the diaphragmatic impression, in patients with large hiatal hernia, and can cause iron deficiency anaemia. CASE REPORT: We present a case of a 56-year-old woman who was referred to our institution for further investigation after she was examined in gastroenterology emergency room (GER) for signs and symptoms of severe hypochromic microcytic anemia without signs of acute gastrointestinal bleeding and with no obvious cause of chronic blood loss. Endoscopy showed linear ulceration at the level of diaphragm-Cameron lesions with large hiated hernia. She was treated with proton pump inhibitors and iron supplements. The laparoscopic fundoplication was done. Six months later she was asymptomatic. CONCLUSION: Large hiatus hernia may cause iron deficiency anemia due to occult bleeding from Cameron erosions. The current therapy concept includes the surgical reconstruction of the hiatus together with gastric fundoplication in combination with the proton pump inhibitor therapy.