1. Premalignant gastric lesions in patients included in National colorectal cancer screeningBojan Tepeš, Maja Šeruga, Miroslav Vujasinović, Dejan Urlep, Liljana Ljepovic, Nataša Brglez Jurecic, Alenka Forte, Anita Kek-Ljubec, Miha Skvarč, 2018, original scientific article Abstract: Background. Gastric cancer is the fifth most common malignancy in the world with almost one million new cases annually. Helicobacter pylori infection causes 89% of all gastric cancers. Premalignant lesions (atrophy and intestinal metaplasia) develop after several decades of inflammation. Secondary prevention with gastroscopy is possible, but it is costly and has a low compliance rate. Alternative procedures like serology testing for pepsinogen I and II and pepsinogen I/II ratio are available to select patients for surveillance gastroscopies. Patients and methods. In seven outpatient endoscopic units, 288 patients (154 men; 53.5%), average age 60.68 years, tested positive in National colorectal cancer screening programme SVIT, were included in the study. Gastropanel (BioHit, Finland) was used as a serologic biopsy method. Results. We found 24 patients (12 men, mean age 63.7 years) with pepsinogen (pepsinogen I/II < 3 and/or pepsinogen I < 30 %g/L). Premalignant changes were found on gastric biopsies in 21 patients (7.3% incidence). Operative Link on Gastric Intestinal Metaplasia Assessment (OLGIM) % 1 was found in 20 patients; Operative Link for Gastritis Assessment (OLGA) % 1 was found in 19 patients. Combined accuracy for preneoplastic lesions in Gastropanel positive patients was 87.5%. H. pylori seropositivity was found in 219 patients (76%). Only 24% of our population had normal results. Conclusions. Gastropanel test has proven to be a reliable non-invasive test for advanced gastric preneoplastic lesions that can select patients for further gastroscopy. We found high H. pylori seropositivity in older age groups in Slovenia.
Keywords: Helicobacter pylori, gastropanel, atrophy, Slovenia, intestinal metaplasia, gastric cancer, SVIT
Published in DiRROS: 02.07.2024; Views: 99; Downloads: 28
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2. Helicobacter pylori treatment results in Slovenia in the period 2013-2015 as a part of European Registry on Helicobacter pylori managementBojan Tepeš, Marko Kastelic, Miroslav Vujasinović, Polona Lampic, Maja Šeruga, Nataša Brglez Jurecic, Olga Perez Nyssen, Maria G. Donday, Colm O'Morain, Francis Megraud, Adrian G. Mcnicholl, Javier P. Gisbert, 2018, original scientific article Abstract: Background. Helicobacter pylori (H. pylori) is the most common chronic bacterial infection in the world affecting over 50% of the world%s population. H. pylori is a grade I carcinogen, responsible for the development of 89 % of noncardia gastric cancers. In the present study we analyzed the data for H. pylori eradication treatments in Slovenia. Patients and methods. Slovenia is a part of the European Registry on Helicobacter pylori Management from the beginning. In seven medical institutions data for H. pylori eradication treatments was collected for 1774 patients from April 16th 2013 to May 15th 2016. For further modified intention to treat (mITT) analysis 1519 patients were eligible and for per protocol (PP) analysis 1346 patients. Results. Patients% dropout was 11.4%. Eradication rate for 7 day triple therapy with proton pump inhibitor (PPI) + Clarithromycin (C) + Amoxicillin (A) was 88.7% PP and 72.0% mITT; for PPI + C + Metronidazole (M) 85.2% PP and 84.4% mITT. Second line 14 day therapy PPI + A + Levofloxacin had 92.3% eradication rate PP and 87.1% mITT. Ten to fourteen day Bismuth quadruple therapy was the therapy in difficult to treat patients. At the end all patients that adhered to prescribed regimens were cured of their H. pylori infection. Conclusions. High dropout rate deserves further analysis. Slovenia is still a country with < 15% H. pylori resistance to clarithromycin, triple therapy with PPI plus two antibiotics reaches PP eradication rate > 85%, but mITT eradication rates are suboptimal.
Keywords: Helicobacter pylori, eradication treatment, European Registry on Helicobacter pylori management, Slovenian results
Published in DiRROS: 02.07.2024; Views: 103; Downloads: 43
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4. Sekundarni maligni tumor debelega črevesja po zdravljenju raka v otroštvuLorna Zadravec-Zaletel, Miroslav Vujasinović, Marko Boc, Berta Jereb, 2014, published professional conference contribution Abstract: Tveganje za nastanek sekundarnega raka debelega črevesja je pri bolnikih, ki so se zdravili zaradi raka v otroštvu, večje od tistega v splošni populaciji in strmo narašča s časom opazovanja ter s povečano dozo obsevanja v predelu trebuha. Pri bolniku, ki je bil v starosti 12 let uspešno zdravljen zaradi Hodgkinove bolezni s kemoterapijo in obsevanjem prizadetih regij, vključno paraaortnih bezgavk, je bila 27 let po zdravljenju ugotovljena mikrocitna hipohromna anemija. Sum, da gre za gastrointestinalno krvavitev z enkratno preiskavo blata, ni bil potrjen. Pol leta kasneje je bil ugotovljen metastatski adenokarcinom debelega črevesja. Zdravljen je bil operativno, s sistemskim zdravljenjem in paliativnim obsevanjem spinalnih ter možganskih metastaz. Leto in pol po začetku zdravljenja sekundarnega tumorja je bolnik v starosti 40 let umrl. Pri bolnikih, zdravljenih zaradi raka v otroštvu, so pozne posledice številne. Sekundarni maligni tumorji so drugi najpogostejši vzrok smrti, takoj za recidivom bolezni. Zato je zelo pomembno, da jih pravočasno odkrijemo in ustrezno zdravimo. Od leta 2014 je za bolnike, ki so prejeli 30 Gy ali več na predel trebuha, v mednarodnih smernicah priporočeno spremljanje s kolonoskopijo. Enkratna preiskava blata na kri in UZ trebuha nista zanesljivi metodi za odkrivanje raka debelega črevesja.
Keywords: kasne posledice raka, rak pri otrocih, rak, otroci
Published in DiRROS: 31.08.2018; Views: 3501; Downloads: 874
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5. S kapecitabinom povzročen transmuralni miokardni infarktMiroslav Vujasinović, Marko Boc, Zdenko Kikec, Cirila Slemenik-Pušnik, 2015, professional article Abstract: Fluoropirimidini so citostatiki, ki jih uvrščamo med tako imenovane antimetabolite (zaviralce celične presnove). Pomembna predstavnika te skupine sta 5-fluorouracil (5-FU) in kapecitabin (peroralni analog 5-FU), ki spadata v skupino t.i. pirimidinskih analogov. Oba predstavljata temelj vseh kemoterapevtskih shem, ki jih uporabljamo pri zdravljenju solidnih tumorjev prebavil in sta kot taka nepogrešljiva pri zdravljenju le-teh. Med redkejše neželene učinke obeh spada kardiotoksičnost, med drugim tudi miokardni infarkt. Spekter s kapecitabinom oz. 5-FU povzročene kardiotoksičnosti je širok in med drugim poleg miokardnega infarkta vključuje angino pektoris, aritmije, kongestivno odpoved srca, kardiogeni šok in nenadno srčno smrt. Zaradi množične uporabe v onkološkem zdravljenju različnih solidnih tumorjev, moramo biti pozorni tudi na možnost kardiotoksičnosti, še posebej pri bolnikih z pridruženo znano ishemično boleznijo srca. Predstavljamo primer bolnice brez predhodno znanih kardiovaskularnih bolezni, pri kateri je prišlo do razvoja transmuralnega miokardnega infarkta tekom terapije s kapecitabinom.
Keywords: kapecitabin, kemoterapija, kardiotoksičnost, srčni infarkt, miokardni infarkt
Published in DiRROS: 19.03.2018; Views: 4208; Downloads: 897
Full text (876,65 KB) |
