High ulcerative colitis and Crohn's disease ratio in a population-based registry from Córdoba, Argentina.

BACKGROUND: Few studies have described the epidemiology and clinical behavior of inflammatory bowel disease (IBD) in South America. The aim of this study was to report on the prevalence, phenotype, and treatment of patients with IBD diagnosis in Capital Department of the Province of Córdoba, Argentina. METHODS: Data from adult patients (≥ 18 years-old) with IBD diagnosis that attended 12 public or private centers between 05/2014 and 05/2019 were included in a common registry. RESULTS: A total of 655 patients were included (females: 53.4%). The ratio of ulcerative colitis (UC) (n = 561) to Crohn's disease (CD) (n = 88) was 6.38, with age-adjusted IBD prevalence being 70.1 (95% confidence interval 70.08-70.12) cases/100,000 habitants. Extraintestinal manifestations were diagnosed in 22.8% of patients, and left-side colitis (46%) was the most frequent extension in UC patients. In CD patients, colonic involvement (55.7%) and non-stricturing/non-penetrating behavior (74%) were the most frequent presentations. Biologic therapy was used in 36.4% of CD patients and 9.1% of UC patients (P<0.001). CONCLUSION: In this population registry study, IBD prevalence was similar to that reported in other series in the region. A higher UC/CD ratio was observed due to the lower prevalence of CD compared to similar studies in South America.

Utilidad de los factores pronósticos para la detección de lesiones pre-neoplásicas de colon / Utility of prognostic factors in the detection of pre-neoplastic colon lesions

INTRODUCCIÓN: El cáncer colorrectal (CCR) representa un problema de salud pública mundial. El objetivo de la participación de los pacientes en programas de screening de cáncer colorrectal (SCCR) es realizar undiagnóstico temprano y reducir la mortalidad. Los estudios endoscópicos son una herramienta clave para estratificar el riesgo y establecer el seguimiento de los pacientes. OBJETIVOS: Determinar la prevalencia de adenomas diagnosticados durante todos los estudios endoscópicos realizados en un periodo de 5 años. Establecer los factores de riesgo asociados a adenomas colorrectales. Estratificar en diferentes tipos de riesgo según la historia clínica del paciente y correlacionarlo con los hallazgos anatomopatológicos de los pólipos y el grado de displasia. PACIENTES Y MÉTODOS: Estudio observacional, retrospectivo, analítico. La población estudiada estuvo conformada por pacientes mayores de 18 años que se realizaron una videocolonoscopía (VCC) en el servicio de Gastroenterología de la Clínica Universitaria Reina Fabiola, en el período comprendido entre 1 diciembre de 2011 y 30 abril de 2017. Las fuentes de datos fueron informes de historia clínica, resultados de estudios endoscópicos y de anatomía patológica.Se analizaron variables demográficas, factores de riesgo para CCR, resultado anatomo-patológico de los pólipos y grado de displasia. Análisis estadístico: Para determinar la relación de diferentes factores de riesgos con el tipo de pólipo obtenido, se realizó un análisis univariado; test de Chi Cuadrado para variables categóricas y test T de Student para variables continuas. Todas las variables significativas en el análisis univariado se incluyeron en un análisis multivariado de regresión logística múltiple. RESULTADOS: La prevalencia de adenomas fue del 26%. Se halló una asociación entre el sexo masculino (p= 0,44), edad mayor a 50 años (p=0,001) y la detección de pólipos durante las colonoscopias de SCCR. Pertenecer a un grupo de riesgo determinado no influyó en el diagnóstico de adenomas (p=0,156). CONCLUSIONES: La prevalencia de pólipos de colon fue similar a la reportada por otros estudios.En el programa de SCCR, se observó una mayor frecuencia de pólipos en pacientes de sexo masculino y mayores de 50 años. Los grupos de riesgo no influyeron en el diagnóstico de adenoma. (AU)

INTRODUCTION: Colorectal cancer (RCC) is an important health problem worldwide. The goal of screening programs is to make early diagnosis and reduces mortality. Colonoscopy is a key tool for stratifying the patients and offer timely surveillance. OBJECTIVES: To determine the prevalence of adenomas diagnosed during all colonoscopy performed over a period of 5 years. To establish associated risk factors. To stratify patients risk according to the clinical history and their correlation with the pathological findings. PATIENTS AND METHODS: This is an observational, retrospective, analytical study. Inclusion criteria: patients over 18 years of age who underwent a colonoscopy for a period of 5 years. Demographic variables and anatomo-pathological result of the polyps were analyzed. Statistical analysis: The characteristics of the simple were analyzed with descriptive statistics. To determine the relationship of different risk factors with the type of polyp obtained, a univariate analysis was performed; Chi Square test for categorical variables and Student's T test for continuous variables. RESULTS: The prevalence of adenomas was 26%. The detection of polyps during SCCR colonoscopies was associated with male sex (p = 0.44), andolder than 50 years (p = 0.001). Belonging to a specific risk group did not influence the diagnosis of adenomas (p = 0.156). CONCLUSION: The prevalence of polyps was similar to that reported by other studies. We found an association between demographic factors (male sex and age) and the detection of polyps during an SCCR program.Belonging to a specific risk group did not influence the diagnosis of adenomas. (AU)

Squamous cell carcinoma in Barrett's esophagus.

Barrett's esophagus (BE), consequence of chronic gastroesophageal reflux disease (GERD), is a premalignant condition, capable of turning into adenocarcinoma (ACa). However, the presence ofsquamous cell carcinoma (SCa) coexisting with Barrett's metaplasia is reported in some papers. The aim of this paper is to present 17 patients involving synchronous BE and SCa.

Giant fibrovascular polyp of the esophagus: a novel technical approach.

Fibrovascular polyps (FVPs) of the esophagus are rare, and their course is usually indolent until reaching enormous proportions. It is a dramatic entity owing to its tendency to cause bizarre complications. We describe a 49-year-old female patient with sudden dyspnoea that required digital maneuvers to clear the airway. After diagnosing, an FVP of the esophagus, a video-assisted endocavitary surgery was made. Histopathological examination revealed a fibrovascular polyp. Endoscopic controls after excision show no mass or symptoms recurrence.

Detection of the risk of adenocarcinoma in Barrett's esophagus by means of tumor markers (p53 and Ki67).

The rising incidence of adenocarcinoma in Barrett's esophagus has intensified the research into methods of early recognition of cancer risk, detecting cytological and architectural changes (dysplasia) or using biomarkers as predictive tests. The aim of this paper is to evaluate the involvement of two tumor markers: p53 (tumor suppressor gene) and Ki67 (proliferation marker), by means of immunohistochemical analysis with monoclonal antibodies designed for the specific localization of p53 and Ki67 antigens, in esophageal biopsies with columnar metaplasia of patients with and without dysplasia and adenocarcinoma, and to anticipate which ones are liable to suffer it in the future. Both markers were positive in all intestinal metaplasia patients with high-grade dysplasia and adenocarcinoma, and even in some cases with low grade or without dysplasia. In contrast, in those who have gastric metaplasia, tumor markers were negative. Expression of biomarkers next to dysplasia reduces interobserver variation. Patients with these abnormalities have to be included into a surveillance protocol.