RESUMO
Barrett's oesophagus is the only known precursor to oesophageal adenocarcinoma, a cancer with very poor prognosis. The main risk factors for Barrett's oesophagus are a history of gastro-oesophageal acid reflux symptoms and obesity. Men, smokers and those with a family history are also at increased risk. Progression from Barrett's oesophagus to cancer occurs via an intermediate stage, known as dysplasia. However, dysplasia and early cancer usually develop without any clinical signs, often in individuals whose symptoms are well controlled by acid suppressant medications; therefore, endoscopic surveillance is recommended to allow for early diagnosis and timely clinical intervention. Individuals with Barrett's oesophagus need to be fully informed about the implications of this diagnosis and the benefits and risks of monitoring strategies. Pharmacological treatments are recommended for control of symptoms, but not for chemoprevention. Dysplasia and stage 1 oesophageal adenocarcinoma have excellent prognoses, since they can be cured with endoscopic or surgical therapies. Endoscopic resection is the most accurate staging technique for early Barrett's-related oesophageal adenocarcinoma. Endoscopic ablation is effective and indicated to eradicate Barrett's oesophagus in patients with dysplasia. Future research should focus on improved accuracy for dysplasia detection via new technologies and providing more robust evidence to support pathways for follow-up and treatment.
Assuntos
Adenocarcinoma , Esôfago de Barrett , Neoplasias Esofágicas , Esôfago de Barrett/terapia , Esôfago de Barrett/patologia , Esôfago de Barrett/diagnóstico , Humanos , Neoplasias Esofágicas/terapia , Neoplasias Esofágicas/patologia , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/etiologia , Adenocarcinoma/patologia , Adenocarcinoma/terapia , Adenocarcinoma/diagnóstico , Esofagoscopia/métodos , Estadiamento de Neoplasias , Progressão da Doença , Fatores de Risco , Lesões Pré-Cancerosas/patologia , Lesões Pré-Cancerosas/terapia , Lesões Pré-Cancerosas/diagnósticoRESUMO
Recently, researchers have proposed an updated model of executive functions that includes relational integration, the mental ability to bind information into more complex structures. Hangover is known to disrupt other core components of executive functions, but little is known about how it influences relational integration. Therefore, this study aimed to investigate how hangover influences performance on a relational integration task. Twenty-seven participants completed an online relational integration task, mood and emotion regulation questionnaires during a hangover and no-hangover condition in this naturalistic design study. Results indicated that relational integration was impaired in hangover (p < 0.001, ηp2 = 0.562) relative to the no-hangover condition. In addition, participants experienced greater difficulties in regulating emotions (p < 0.001, d = 0.85) and lower mood (p < 0.001, d = 0.88) during hangover. These results suggest that relational integration is impaired in hangover and add weight to the argument that cognitive impairments in hangover may be due to the hangover-related impact on domain-general processing resources.