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Bandiera S, Almeida FB, Hansen AW, Pulcinelli RR, Caletti G, de Paula LF, Nin MS, Fontella FU, Almeida RF, Tannhauser Barros HM, Gomez R. Combined use of alcohol and cigarette increases locomotion and glutamate levels in the cerebrospinal fluid without changes on GABAA or NMDA receptor subunit mRNA expression in the hippocampus of rats. Behav Brain Res 2020; 380:112444. [DOI: 10.1016/j.bbr.2019.112444] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 11/18/2019] [Accepted: 12/18/2019] [Indexed: 10/25/2022]
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Hansen AW, Almeida FB, Bandiera S, Pulcinelli RR, Caletti G, Agnes G, Fernandes de Paula L, Nietiedt NA, Nin MS, Tannhauser Barros HM, Gomez R. Correlations between subunits of GABA A and NMDA receptors after chronic alcohol treatment or withdrawal, and the effect of taurine in the hippocampus of rats. Alcohol 2020; 82:63-70. [PMID: 31473305 DOI: 10.1016/j.alcohol.2019.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 08/15/2019] [Accepted: 08/19/2019] [Indexed: 11/18/2022]
Abstract
Chronic use of alcohol and its withdrawal impairs the delicate balance between GABAergic and glutamatergic systems. This imbalance includes changes in GABA receptors - importantly in GABAA subtypes - and glutamate receptors, especially in NMDA subtypes. A better comprehension of the different roles of GABAAR and NMDAR subunits could be helpful to define new strategies to counteract the deleterious effects observed during alcohol withdrawal. Taurine, a sulfonated amino acid, has been proposed to attenuate alcohol withdrawal symptoms due to its neuromodulatory properties. In this study, we evaluated the correlations between GABAAR and NMDAR subunits in the hippocampus of rats chronically treated with alcohol or in alcohol withdrawal, and the effects of taurine treatment on these parameters. Male Wistar rats received alcohol (2 g/kg) or water by oral gavage (control), 2 × /day, for 28 days. From day 29 to day 33, withdrawal rats received water instead of alcohol and all groups were reallocated to receive 100 mg/kg taurine or saline intraperitoneally (i.p.), once a day. On day 34, rats were euthanized and the hippocampus was dissected for GABAAR α1, α4, δ, and γ2 and NMDAR GluN2A and GluN2B subunits mRNA expression determination by RT qPCR. There were no differences between groups in the studied GABAAR and NMDA subunits. However, we observed a correlation of α1 and γ2 subunits induced by taurine, while in the alcohol group there was a correlation between α4 and GluN2A. In the group treated with alcohol and taurine, we observed an extra correlation, between α1 and GluN2A. After 5 days of withdrawal, a correlation observed in the control group, between δ and GluN2A, was reestablished. The correlation found between subunits suggests a neuroadaptation of GABAergic and glutamatergic systems in withdrawal rats. Results from this study contribute to the elucidation of the mechanisms beyond neuroadaptations observed in alcohol use and withdrawal.
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Affiliation(s)
- Alana Witt Hansen
- Programa de Pós-Graduação em Ciências Biológicas: Farmacologia e Terapêutica, Laboratório de Álcool e Tabaco (LAT), Universidade Federal do Rio Grande do Sul - UFRGS, Sarmento Leite, 500, 90050-170, Porto Alegre, RS, Brazil.
| | - Felipe Borges Almeida
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre - UFCSPA, Sarmento Leite, 245, 90050-170, Porto Alegre, RS, Brazil
| | - Solange Bandiera
- Programa de Pós-Graduação em Ciências Biológicas: Farmacologia e Terapêutica, Laboratório de Álcool e Tabaco (LAT), Universidade Federal do Rio Grande do Sul - UFRGS, Sarmento Leite, 500, 90050-170, Porto Alegre, RS, Brazil
| | - Rianne Remus Pulcinelli
- Programa de Pós-Graduação em Ciências Biológicas: Farmacologia e Terapêutica, Laboratório de Álcool e Tabaco (LAT), Universidade Federal do Rio Grande do Sul - UFRGS, Sarmento Leite, 500, 90050-170, Porto Alegre, RS, Brazil
| | - Greice Caletti
- Programa de Pós-Graduação em Ciências Biológicas: Farmacologia e Terapêutica, Laboratório de Álcool e Tabaco (LAT), Universidade Federal do Rio Grande do Sul - UFRGS, Sarmento Leite, 500, 90050-170, Porto Alegre, RS, Brazil
| | - Grasiela Agnes
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre - UFCSPA, Sarmento Leite, 245, 90050-170, Porto Alegre, RS, Brazil
| | - Leonardo Fernandes de Paula
- Programa de Pós-Graduação em Ciências Biológicas: Farmacologia e Terapêutica, Laboratório de Álcool e Tabaco (LAT), Universidade Federal do Rio Grande do Sul - UFRGS, Sarmento Leite, 500, 90050-170, Porto Alegre, RS, Brazil
| | - Natália Azuaga Nietiedt
- Programa de Pós-Graduação em Ciências Biológicas: Farmacologia e Terapêutica, Laboratório de Álcool e Tabaco (LAT), Universidade Federal do Rio Grande do Sul - UFRGS, Sarmento Leite, 500, 90050-170, Porto Alegre, RS, Brazil
| | - Maurício Schüler Nin
- Programa de Pós-Graduação em Ciências Biológicas: Farmacologia e Terapêutica, Laboratório de Álcool e Tabaco (LAT), Universidade Federal do Rio Grande do Sul - UFRGS, Sarmento Leite, 500, 90050-170, Porto Alegre, RS, Brazil; Centro Universitário Metodista do IPA, Cel. Joaquim Pedro Salgado, 80, 90420-060, Porto Alegre, RS, Brazil
| | - Helena Maria Tannhauser Barros
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre - UFCSPA, Sarmento Leite, 245, 90050-170, Porto Alegre, RS, Brazil
| | - Rosane Gomez
- Programa de Pós-Graduação em Ciências Biológicas: Farmacologia e Terapêutica, Laboratório de Álcool e Tabaco (LAT), Universidade Federal do Rio Grande do Sul - UFRGS, Sarmento Leite, 500, 90050-170, Porto Alegre, RS, Brazil; Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre - UFCSPA, Sarmento Leite, 245, 90050-170, Porto Alegre, RS, Brazil
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Boehm R, Cohen C, Pulcinelli R, Caletti G, Balsan A, Nascimento S, Rocha R, Calderon E, Saint’Pierre T, Garcia S, Sekine L, Onsten T, Gioda A, Gomez R. Toxic elements in packed red blood cells from smoker donors: a risk for paediatric transfusion? Vox Sang 2019; 114:808-815. [DOI: 10.1111/vox.12854] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 08/22/2019] [Accepted: 09/14/2019] [Indexed: 12/27/2022]
Affiliation(s)
- Renata Boehm
- Programa de Pós‐Graduação em Farmacologia e Terapêutica Universidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre Brazil
- Serviço de Hemoterapia do Hospital de Clínicas de Porto Alegre (HCPA) Porto Alegre Brazil
| | - Carolina Cohen
- Serviço de Hemoterapia do Hospital de Clínicas de Porto Alegre (HCPA) Porto Alegre Brazil
| | - Rianne Pulcinelli
- Programa de Pós‐Graduação em Farmacologia e Terapêutica Universidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre Brazil
| | - Greice Caletti
- Programa de Pós‐Graduação em Farmacologia e Terapêutica Universidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre Brazil
| | - Almeri Balsan
- Serviço de Hemoterapia do Hospital de Clínicas de Porto Alegre (HCPA) Porto Alegre Brazil
| | - Sabrina Nascimento
- Laboratório de Toxicologia (LATOX) Departamento de Análises Universidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre Brazil
| | - Rafael Rocha
- Departamento de Química Pontifícia Universidade Católica do Rio de Janeiro (PUC‐ Rio) Rio de Janeiro Brazil
| | - Enrique Calderon
- Departamento de Química Pontifícia Universidade Católica do Rio de Janeiro (PUC‐ Rio) Rio de Janeiro Brazil
| | - Tatiana Saint’Pierre
- Departamento de Química Pontifícia Universidade Católica do Rio de Janeiro (PUC‐ Rio) Rio de Janeiro Brazil
| | - Solange Garcia
- Laboratório de Toxicologia (LATOX) Departamento de Análises Universidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre Brazil
| | - Leo Sekine
- Serviço de Hemoterapia do Hospital de Clínicas de Porto Alegre (HCPA) Porto Alegre Brazil
| | - Tor Onsten
- Serviço de Hemoterapia do Hospital de Clínicas de Porto Alegre (HCPA) Porto Alegre Brazil
| | - Adriana Gioda
- Departamento de Química Pontifícia Universidade Católica do Rio de Janeiro (PUC‐ Rio) Rio de Janeiro Brazil
| | - Rosane Gomez
- Programa de Pós‐Graduação em Farmacologia e Terapêutica Universidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre Brazil
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Nin MS, Almeida FB, Silva FFD, Fonseca AR, Feddern CF, Caletti G, Gomez R, Barros HM. Hemispherical asymmetry in reports gene or protein expression related to mood disorders in the brain of rodents: A pilot systematic review. IBRO Rep 2019. [DOI: 10.1016/j.ibror.2019.07.1501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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A. Quinteros D, Witt Hansen A, Bellaver B, Bobermin LD, R. Pulcinelli R, Bandiera S, Caletti G, Bitencourt PER, Quincozes-Santos A, Gomez R. Combined Exposure to Alcohol and Tobacco Smoke Changes Oxidative, Inflammatory, and Neurotrophic Parameters in Different Areas of the Brains of Rats. ACS Chem Neurosci 2019; 10:1336-1346. [PMID: 30653286 DOI: 10.1021/acschemneuro.8b00412] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Devastating effects of exposure to alcohol and tobacco smoke on health are extensively reported in the literature. However, few studies have attempted to elucidate the consequences of their combined use on the central nervous system. Here we studied the effect of this combined use on some oxidative, inflammatory, and neurotrophic parameters in the hippocampus, striatum, and frontal cortex of rats. Adult Wistar rats were allocated into control (CT), alcohol (AL), tobacco smoke (TB), or combined (ALTB) groups. Rats were exposed to environmental air (CT and AL groups) or to the smoke from six cigarettes (TB and ALTB groups) immediately after tap water (CT and TB) or 2 g of alcohol/kg (AL and ALTB) oral gavage administration, twice a day, for 4 weeks. On day 28, rats were euthanized and areas of the brain were dissected to evaluate some cellular redox parameters, pro-inflammatory cytokine levels, and brain-derived neurotrophic factor (BDNF) levels. A one-way analysis of variance showed that the ALTB combined treatment significantly increased oxidative stress levels in the hippocampus. ALTB also increased interleukin-1β levels in the striatum and frontal cortex and tumoral necrosis factor-α levels in the frontal cortex compared with those of AL, TB, and CT rats. Combined treatment also decreased the BDNF levels in the frontal cortex of rats. Oxidative damage was found, more importantly, in the hippocampus, and inflammatory parameters were extended to all areas of the brain that were studied. Our results showed an interaction between alcohol and tobacco smoke according to the area of the brain, suggesting an additional risk of neural damage in alcoholics who smoke.
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Affiliation(s)
- Dayane A. Quinteros
- Programa de Pós-Graduação em Ciência Biológicas: Farmacologia e Terapêutica (PPGFT), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90040-060, Brazil
| | - Alana Witt Hansen
- Programa de Pós-Graduação em Ciência Biológicas: Farmacologia e Terapêutica (PPGFT), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90040-060, Brazil
| | - Bruna Bellaver
- Programa de Pós-Graduação em Ciência Biológicas: Bioquímica, UFRGS, Porto Alegre 90050-170, Brazil
| | - Larissa D. Bobermin
- Programa de Pós-Graduação em Ciência Biológicas: Bioquímica, UFRGS, Porto Alegre 90050-170, Brazil
| | - Rianne R. Pulcinelli
- Programa de Pós-Graduação em Ciência Biológicas: Farmacologia e Terapêutica (PPGFT), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90040-060, Brazil
| | - Solange Bandiera
- Programa de Pós-Graduação em Ciência Biológicas: Farmacologia e Terapêutica (PPGFT), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90040-060, Brazil
| | - Greice Caletti
- Programa de Pós-Graduação em Ciência Biológicas: Farmacologia e Terapêutica (PPGFT), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90040-060, Brazil
| | - Paula E. R. Bitencourt
- Programa de Pós-Graduação em Ciência Biológicas: Farmacologia e Terapêutica (PPGFT), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90040-060, Brazil
| | - André Quincozes-Santos
- Programa de Pós-Graduação em Ciência Biológicas: Bioquímica, UFRGS, Porto Alegre 90050-170, Brazil
| | - Rosane Gomez
- Programa de Pós-Graduação em Ciência Biológicas: Farmacologia e Terapêutica (PPGFT), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90040-060, Brazil
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Gomez R, Caletti G, Arbo BD, Hoefel AL, Schneider R, Hansen AW, Pulcinelli RR, Freese L, Bandiera S, Kucharski LC, Barros HMT. Acute intraperitoneal administration of taurine decreases the glycemia and reduces food intake in type 1 diabetic rats. Biomed Pharmacother 2018; 103:1028-1034. [PMID: 29710660 DOI: 10.1016/j.biopha.2018.04.131] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 04/17/2018] [Accepted: 04/17/2018] [Indexed: 10/17/2022] Open
Abstract
Taurine, an amino acid with antioxidant and osmoregulatory properties, has been studied for its possible antidiabetic properties in type 1 and type 2 diabetic animals. In type 2 diabetic mice, taurine decreases blood glucose through increased insulin secretion and insulin receptor sensitization. However, insulin is absent in type 1 diabetic individuals. The aim of this study was to evaluate the effects of taurine on parameters related to the energy balance that could explain the metabolic action of this amino acid in type 1 diabetic rats. Control and streptozotocin-induced diabetic rats received saline or taurine (100 mg/kg/day), intraperitoneally, for 30 days. Parameters such as palatable food intake, gastrointestinal transit rate, serum glucose, insulin, leptin, and glucagon levels were measured 60 min after the last taurine administration. Liver, kidneys, heart, and retroperitoneal fat were dissected and weighted. Glycogen levels were measured in the liver and soleus muscle. Our results showed that acute taurine administration decreased glycemia. It also decreased food intake in diabetic rats, without affecting other metabolic parameters. Altogether, our results suggest that in type 1 diabetic rats, taurine decreases blood glucose by a non-insulin-dependent mechanism. Due to the safety profile of taurine, and its effect on glycemia, this amino acid may help to design new drugs to add benefit to insulin therapy in type 1 diabetic individuals.
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Affiliation(s)
- Rosane Gomez
- Programa de Pós-Graduação em Farmacologia e Terapêutica, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil; Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre (UFSCPA), Brazil; Programa de Pós-Graduação em Neurociências, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil.
| | - Greice Caletti
- Programa de Pós-Graduação em Farmacologia e Terapêutica, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil; Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre (UFSCPA), Brazil
| | - Bruno Dutra Arbo
- Instituto de Ciências Biológicas, Universidade Federal do Rio Grande (FURG), Brazil
| | - Ana Lúcia Hoefel
- Programa de Pós-Graduação em Fisiologia, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil
| | - Ricardo Schneider
- Programa de Pós-Graduação em Neurociências, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil
| | - Alana Witt Hansen
- Programa de Pós-Graduação em Farmacologia e Terapêutica, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil
| | - Rianne Remus Pulcinelli
- Programa de Pós-Graduação em Farmacologia e Terapêutica, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil
| | - Luana Freese
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre (UFSCPA), Brazil
| | - Solange Bandiera
- Programa de Pós-Graduação em Farmacologia e Terapêutica, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil
| | - Luiz Carlos Kucharski
- Programa de Pós-Graduação em Fisiologia, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil
| | - Helena Maria Tanhauser Barros
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre (UFSCPA), Brazil
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Serrani M, Caletti G, Fusaroli P. Contrast enhancement and elastography in endoscopic ultrasound: an overview of clinical applications in pancreatic diseases. Minerva Med 2014; 105:353-361. [PMID: 25028864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Endoscopic ultrasound is a very accurate imaging technique with a relevant clinical impact in the diagnosis and staging of various conditions such as pancreaticobiliary lesions, esophageal cancer, lung cancer, submucosal lesions and lymph nodes. Despite its increasing importance in everyday clinical routine, endoscopic ultrasound outcomes are still highly operator-dependent and tissue confirmation with fine needle aspiration is very often required for definitive differential diagnosis of tumors. Several techniques of image enhancement have been developed in recent years in the attempt to make the technique less operator-dependent. Among them the most important appear to be contrast harmonic-endoscopic ultrasound and endoscopic ultrasound-elastography. Contrast harmonic-endoscopic ultrasound is performed with a dedicated harmonic which displays the fine vascular network of both normal and pathological tissues after injection of an ultrasound contrast agent. Endoscopic ultrasound-elastography displays with different colors the differences in hardness between tissues, thus estimating elasticity in soft normal tissues which appear red and hard neoplastic tissues which appear blue. While contrast harmonic-endoscopic ultrasound has been introduced into clinical practice, endoscopic ultrasound-elastography mainly represents an investigational tool. The purpose of this paper was to review the mechanism of action and the clinical outcomes of contrast harmonic-endoscopic ultrasound and endoscopic ultrasound-elastography in pancreatic diseases. Both techniques show promising applications in the study of pancreatic tumors including differential diagnosis and providing guidance to fine needle aspiration.
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Affiliation(s)
- M Serrani
- Department of Medical and Surgical Sciences University of Bologna/Hospital of Imola, Imola, Italy -
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Souza MF, Couto-Pereira NS, Freese L, Costa PA, Caletti G, Bisognin KM, Nin MS, Gomez R, Barros HMT. Behavioral effects of endogenous or exogenous estradiol and progesterone on cocaine sensitization in female rats. ACTA ACUST UNITED AC 2014; 47:505-14. [PMID: 24878606 PMCID: PMC4086178 DOI: 10.1590/1414-431x20143627] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 03/06/2014] [Indexed: 11/21/2022]
Abstract
Cocaine sensitization is a marker for some facets of addiction, is greater in female rats, and may be influenced by their sex hormones. We compared the modulatory effects of endogenous or exogenous estradiol and progesterone on cocaine-induced behavioral sensitization in 106 female rats. Ovariectomized female rats received progesterone (0.5 mg/mL), estradiol (0.05 mg/mL), progesterone plus estradiol, or the oil vehicle. Sham-operated control females received oil. Control and acute subgroups received injections of saline, while the repeated group received cocaine (15 mg/kg, ip) for 8 days. After 10 days, the acute and repeated groups received a challenge dose of cocaine, after which locomotion and stereotypy were monitored. The estrous cycle phase was evaluated and blood was collected to verify hormone levels. Repeated cocaine treatment induced overall behavioral sensitization in female rats, with increased locomotion and stereotypies. In detailed analysis, ovariectomized rats showed no locomotor sensitization; however, the sensitization of stereotypies was maintained. Only females with endogenous estradiol and progesterone demonstrated increased locomotor activity after cocaine challenge. Estradiol replacement enhanced stereotyped behaviors after repeated cocaine administration. Cocaine sensitization of stereotyped behaviors in female rats was reduced after progesterone replacement, either alone or concomitant with estradiol. The behavioral responses (locomotion and stereotypy) to cocaine were affected differently, depending on whether the female hormones were of an endogenous or exogenous origin. Therefore, hormonal cycling appears to be an important factor in the sensitization of females. Although estradiol increases the risk of cocaine sensitization, progesterone warrants further study as a pharmacological treatment in the prevention of psychostimulant abuse.
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Affiliation(s)
- M F Souza
- Laboratório de Neurociência Comportamental, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brasil
| | - N S Couto-Pereira
- Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - L Freese
- Laboratório de Neurociência Comportamental, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brasil
| | - P A Costa
- Laboratório de Neurociência Comportamental, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brasil
| | - G Caletti
- Laboratório de Neurociência Comportamental, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brasil
| | - K M Bisognin
- Laboratório de Neurociência Comportamental, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brasil
| | - M S Nin
- Laboratório de Neurociência Comportamental, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brasil
| | - R Gomez
- Departamento de Farmacologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - H M T Barros
- Laboratório de Neurociência Comportamental, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brasil
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Fusaroli P, Caletti G. Endoscopic Ultrasound Staging of Gastric Lymphoma. Video Journal and Encyclopedia of GI Endoscopy 2013; 1:148-150. [DOI: 10.1016/s2212-0971(13)70061-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
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Affiliation(s)
- P Fusaroli
- Department of Clinical Medicine, GI Unit, University of Bologna/Hospital of Imola, Bologna, Italy
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Affiliation(s)
- G Caletti
- Department of Gastroenterology, University of Bologna/Imola Hospital, Castel San Pietro Terme, Italy.
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Fusaroli P, Cecinato P, Garulli L, Poli F, Caletti G. Massive mucinous discharge from a fistula caused by intraductal papillary mucinous neoplasm diagnosed by endoscopic ultrasound. Endoscopy 2012; 43 Suppl 2 UCTN:E360-1. [PMID: 22068644 DOI: 10.1055/s-0030-1256588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- P Fusaroli
- Department of Clinical Medicine, Gastroenterology Unit, University of Bologna/Imola Hospital, Bologna, Italy.
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Fusaroli P, Grillo A, Zanarini S, Caletti G. Usefulness of a second endoscopic arm to improve therapeutic endoscopy in the lower gastrointestinal tract. Preliminary experience - a case series. Endoscopy 2009; 41:997-1000. [PMID: 19802777 DOI: 10.1055/s-0029-1215190] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Endoscopic submucosal dissection is a difficult procedure with frequent complications. Our aim was to test the feasibility of utilizing a second endoscopic arm to improve the dissection. An Olympus prototype blind probe, with an external diameter of 6 mm and a 2.8-mm working channel, was used as a second endoscopic arm. Its purpose was to lift the lesion during dissection. The main endoscope served both to perform the dissection and to visualize the second endoscopic arm in the monitor. Eight patients with polypoid lesions in the rectum or distal sigmoid were treated successfully. The procedure was feasible, and submucosal exposure was ameliorated allowing easier dissection. The resection was curative in all cases. No recurrences have been detected during up to 18-months of follow-up. A small perforation and two cases of delayed bleeding were managed nonsurgically. Applying counter-traction with a second endoscopic arm can facilitate submucosal dissection of distal colorectal lesions.
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Affiliation(s)
- P Fusaroli
- Department of Gastroenterology, University of Bologna/Azienda USL di Imola, Bologna, Italy.
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Affiliation(s)
- A Grillo
- Institute of Internal Medicine, Catholic University, Rome, Italy
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Fusaroli P, Manta R, Fedeli P, Maltoni S, Grillo A, Giovannini E, Bucchi L, Caletti G. The influence of endoscopic biliary stents on the accuracy of endoscopic ultrasound for pancreatic head cancer staging. Endoscopy 2007; 39:813-7. [PMID: 17703391 DOI: 10.1055/s-2007-966590] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
BACKGROUND AND STUDY AIMS Biliary stents have been found to interfere with endoscopic ultrasound (EUS) tumor (T) and nodal (N) staging in patients with periampullary cancer. Our aim was to determine whether this also occurs in patients with pancreatic head cancer. PATIENTS AND METHODS We studied a consecutive series of patients who were undergoing preoperative EUS for diagnosis and staging of suspected pancreatic cancer, some of whom had biliary stents in situ and some of whom did not. The main end point was the uni- and multivariate association of biliary stenting with T and N mis-staging by EUS. The surgical T and N stages were used as gold standards. RESULTS A total of 65 patients were identified (19 with biliary stents in situ and 46 without). Surgical stage T4 was found more frequently in patients with stents (53% vs. 22%, P = 0.014). The T stage by EUS was correct in 85% of the patients without biliary stents and in 47% of the patients with stents. The frequency of mis-staging by EUS was significant only among patients with a biliary stent. The distribution by EUS N stage did not differ significantly from the surgical N-stage distribution in the two groups of patients. According to the multivariate analysis, patients with stents were 6.55 times more likely to be incorrectly T staged (95% confidence interval [CI] 1.69-25.49) and 3.71 times more likely to be incorrectly N staged (95% CI 1.11-12.45) than patients without stents. CONCLUSIONS The results add support to the recommendation that EUS staging of pancreatic head neoplasms should be performed prior to stent placement.
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Affiliation(s)
- P Fusaroli
- Gastroenterology Unit, University of Bologna/AUSL di Imola, Castel S. Pietro Terme Hospital, Castel S. Pietro Terme, Italy.
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17
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Affiliation(s)
- P Fusaroli
- Gastroenterology Unit, University of Bologna AUSL di Imola, Ospedale di Castel S. Pietro Terme, Bologna, Italy
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18
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Ye H, Gong L, Liu H, Ruskone-Fourmestraux A, de Jong D, Pileri S, Thiede C, Lavergne A, Boot H, Caletti G, Wündisch T, Molina T, Taal BG, Elena S, Neubauer A, Maclennan KA, Siebert R, Remstein ED, Dogan A, Du MQ. Strong BCL10 nuclear expression identifies gastric MALT lymphomas that do not respond to H pylori eradication. Gut 2006; 55:137-8. [PMID: 16344587 PMCID: PMC1856390 DOI: 10.1136/gut.2005.081117] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
MESH Headings
- Adaptor Proteins, Signal Transducing/genetics
- Adult
- Aged
- B-Cell CLL-Lymphoma 10 Protein
- Chromosomes, Human, Pair 1
- Chromosomes, Human, Pair 14
- Female
- Helicobacter Infections/genetics
- Helicobacter Infections/therapy
- Helicobacter pylori
- Humans
- Lymphoma, B-Cell, Marginal Zone/genetics
- Lymphoma, B-Cell, Marginal Zone/therapy
- Male
- Middle Aged
- Neoplasm Proteins/genetics
- Stomach Neoplasms/genetics
- Translocation, Genetic
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19
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Tucci A, Tucci P, Bisceglia M, Marchegiani A, Papadopoli G, Fusaroli P, Spada A, Pistoletto MO, Pistoletto MO, Cristino M, Poli L, Villani A, Bucci M, Marinelli M, Caletti G. Real-time detection of Helicobacter Pylori infection and atrophic gastritis: comparison between conventional methods and a novel device for gastric juice analysis during endoscopy. Endoscopy 2005; 37:966-76. [PMID: 16189769 DOI: 10.1055/s-2005-870373] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
BACKGROUND AND STUDY AIMS Gastric juice may represent a valuable source of clinicopathological information if properly analyzed. We evaluated the reliability and clinical validity of data obtained using an innovative device (the "Mt 21-42") that analyzes gastric juice, thus allowing the identification of Helicobacter pylori infection and atrophic gastritis of the oxyntic mucosa during endoscopy. METHODS Validation studies were carried out to evaluate the measuring performance of the device. In addition, the H. pylori status and the presence of atrophic gastritis were assessed in 150 patients undergoing upper gastrointestinal endoscopy. In all these patients the Mt 21-42 device was used to assist endoscopy. Conventional tests (involving histology, urease testing, urea breath testing, anti- H. pylori IgG, serum gastrin, pepsinogen, intrinsic factor and parietal cells autoantibodies, vitamin B12, and folate) were also performed for comparison with the Mt 21-42 results. RESULTS The measuring performance of the Mt 21-42 was good; for pH, the relative percent error and the coefficient of variation were 1.9 % +/- 4.2 and 1.3 %, respectively, and for ammonium they were 0.1 % +/- 0.2 % and 2.1 %. For the detection of H. pylori infection, the sensitivity and specificity of the device (96.7 % and 94.3 %) were similar to those of the urea breath test (90.5 % and 93.3 %) and serology (87.1 % and 88.8 %), and higher than those of the urease test (78.6 % and 98.7 %; P < 0.01) and routine histology (94.3 % and 76.3 %; P < 0.05). When compared with the currently available standard methods, use of the Mt 21-42 was found to be the most sensitive technique for the detection of atrophy (94.7 % vs. 5.3 % - 47.4 %; P < 0.001); the device failed to detect the disease in only one case (5 %), whereas failure rates of 53 % - 95 % were reported with the conventional methods. CONCLUSION Atrophic gastritis of the oxyntic mucosa is a risky condition that often goes undetected in current clinical practice. The Mt 21-42 is an effective, useful, and desirable tool that may help to overcome this diagnostic limitation; it produces time and cost savings and also allows the detection of H. pylori infection.
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Affiliation(s)
- A Tucci
- Gastrointestinal Unit, University of Bologna, AUSL of Imola, Castel S. Pietro Terme Hospital, Italy.
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20
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Annese V, Caletti G, Cipolletta L, Costamagna G, D'Onofrio V, Leandro G, Koch M, Pace F, Penagini R, Repici A, Ricci E, Vigneri S, Zaninotto G. Endoscopic treatment of gastroesophageal reflux disease. Endoscopy 2005; 37:470-8. [PMID: 15844028 DOI: 10.1055/s-2005-861194] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Gastroesophageal reflux disease is a common chronic disorder which has a severe effect on the patient's quality of life. In view of the high cost of medical therapy and the limitations of surgery, a variety of endoscopic techniques have been developed for the treatment of this condition, and these have shown apparently encouraging results, at least in the short term. However, promising results have been obtained in only around two-thirds of patients over a short-term follow-up period of about 6 months. Moreover, several inconsistencies have emerged between the efficacy of this form of treatment in improving symptoms and quality of life and a lack of improvement of objective parameters, such as lower esophageal sphincter pressure and esophageal acid exposure. The authors strongly endorse the need for comprehensive evaluation of clinical evidence on this topic. After an extensive evaluation of existing literature, we suggest that controlled studies are urgently needed in order to clarify the potential of endoscopic therapy, either in terms of cost-effectiveness or in comparison with standard therapy. Meanwhile, with regard to current practice, the use of endoscopic treatment should be limited to clinical trials, which should incorporate the provision of comprehensive and unbiased information to study patients.
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Affiliation(s)
- V Annese
- U.O. Gastroenterologia, Ospedale CSS-IRCCS, San Giovanni Rotondo, Italy.
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Abstract
Endoscopic ultrasonography and endoscopic ultrasonography-guided fine needle aspiration are well-established techniques, encompassing a variety of diagnostic and therapeutic applications. Along with traditional indications that constitute everyday clinical practice in all endoscopic ultrasonography centres, new indications are emerging that resemble the continuing research carried on in this field. Some of these are innovative applications, developed by highly experienced endosonographers and with a putative role for clinical practice in the near future. Others are merely experimental applications, carried out on in animal models or in highly selected groups of patients, opening up new fascinating areas of research but not for imminent introduction in clinical practice. The purpose of this review, after summarising the present indications of endoscopic ultrasonography, is to focus on the future applications and try to establish their possible advent, either in the near or in the far future.
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Affiliation(s)
- P Fusaroli
- University of Bologna, Imola, AUSL, Castel S. Pietro Terme Hospital (BO), Viale Oriani 1, Castel S. Pietro Terme, Bologna 1-40024, Italy
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22
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Caletti G, Fusaroli P. Quel futur pour l’EE? Acta Endosc 2005; 35:53-58. [DOI: 10.1007/bf03002648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
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Fusaroli P, Maltoni S, Caletti G. Indications de la ponction-biopsie à l’aiguille fine sous écho-endoscopie (EUS-FNA) dans Les kystes pancréatiques. Acta Endosc 2005; 35:11-16. [DOI: 10.1007/bf03002642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
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Abstract
This paper covers the literature published between June 2003 and August 2004 on endoscopic ultrasonography (EUS) and EUS-guided fine-needle aspiration (FNA). During this period, more than 120 original studies were published on the topic, not to mention editorials and case reports--indirect evidence of the ever-increasing importance of EUS in everyday clinical practice. However, due to limitations of space, this review will focus only on a few articles selected for their importance and originality. The studies presented deal either with the outcome of EUS--i. e., its real importance in affecting the choices physicians are faced with in their clinical work--or definitively clarify certain technical issues that have often been a matter of debate at EUS meetings. Finally, a few papers describing new potential diagnostic or interventional applications of EUS are presented. Many other relevant papers in addition to those discussed in detail are cited in the references.
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Affiliation(s)
- P Fusaroli
- Gastroenterology Unit, University of Bologna, Bologna Unit, Italy
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25
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Abstract
This review again uses a practical arrangement of the topics of endoscopic ultrasonography (EUS) into clinical categories rather than single diseases. The clinical categories include established indications, such as staging of gastrointestinal tract cancers, differential diagnosis of submucosal tumors, evaluation of solid and cystic pancreatic masses, detection of lymph nodes, evaluation of the biliary tree, and fine-needle aspiration (FNA). In addition to established indications, surgical and investigational techniques are presented, such as fine-needle therapeutic procedures and methods of studying portal hypertension and hepatic, abdominal, and retroperitoneal masses. This year, the new techniques and instruments presented have not included new probes or endoscopes, as these have already gained wide application in published papers and clinical practice. However, new techniques capable of facilitating the use of existing equipment are discussed, such as computer-aided EUS image analysis. Finally, some fascinating studies investigated outcomes with EUS and the cost-effectiveness of the method - stimulating both endosonographers and non-endosonographers to think about current practices and ways of improving them.
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Affiliation(s)
- P Fusaroli
- Gastrointestinal Unit, Castel S. Pietro Terme Hospital, University of Bologna, Bologna, Italy
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26
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Caletti G, Zinzani PL, Fusaroli P, Buscarini E, Parente F, Federici T, Peyre S, De Angelis C, Bonanno G, Togliani T, Pileri S, Tura S. The importance of endoscopic ultrasonography in the management of low-grade gastric mucosa-associated lymphoid tissue lymphoma. Aliment Pharmacol Ther 2002; 16:1715-22. [PMID: 12269963 DOI: 10.1046/j.1365-2036.2002.01334.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Anti-Helicobacter pylori therapy has been reported to cause regression of low-grade gastric mucosa-associated lymphoid tissue lymphoma in a high percentage of patients. However, in some patients, these lesions persist despite antibiotic treatment. AIM To determine the various endosonographic findings that may predict the regression of low-grade gastric mucosa-associated lymphoid tissue lymphoma post-antibiotics. METHODS Seventy-six patients with Helicobacter pylori-positive gastric mucosa-associated lymphoid tissue lymphoma were studied. Follow-up data were available on 51 patients. All patients were treated with antibiotics. Participants underwent pre- and post-anti-Helicobacter pylori therapy endoscopy with gastric biopsies, followed by endoscopic ultrasonography examination of the stomach. RESULTS Helicobacter pylori was eradicated in 45 of 51 (88%) patients. At the 2-year follow-up, complete regression of mucosa-associated lymphoid tissue lymphoma was seen in 28 of 51 (55%) patients: 12 of 16 (75%) patients in stage T1m N0, 11 of 19 (58%) patients in stage T1sm N0, four of eight (50%) patients in stages T1m N1 and T1sm N1, and one of four (25%) patients in stage T2 N0. None of the stage T2 N1 patients achieved clinical regression. CONCLUSIONS Endoscopic ultrasonography evaluation of gastric mucosa-associated lymphoid tissue lymphoma plays a pivotal role in the initial staging and post-treatment follow-up evaluation of these lesions. Accurate staging is essential in the determination of the optimal treatment modality.
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Affiliation(s)
- G Caletti
- Department of Internal Medicine and Gastroenterology, University of Bologna, Italy.
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27
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Abstract
BACKGROUND AND STUDY AIMS Endoscopic ultrasound imaging of mediastinum, gastrointestinal tract and pancreas, and endoscopic ultrasound-guided fine-needle aspiration of suspicious lesions, have now been available for several years. Although many papers have been published on endoscopic ultrasonography, a comprehensive overview of the subject matter presented has not yet been carried out. An extensive survey of the literature on endoscopic ultrasonography since its inception in the 1980 s was conducted in this study; key points are summarized. METHODS A computer-based PubMed search system was used to retrieve all available abstracts pertaining to endoscopic ultrasound from 1980 to the present. Data were collected concerning the impact factor, the various EUS instruments and fine-needle aspiration biopsy techniques used, and the subject matter, as well as the journals publishing the abstracts. RESULTS A total of 1259 articles were published in 65 journals: 440 (35 %) Western European studies, 404 (32 %) American studies, and 321 (26 %) Japanese studies were retrieved. The total and average impact factor per paper was highest for American papers, followed by European papers and Japanese papers. Forty-seven percent of the papers were published in Gastrointestinal Endoscopy and Endoscopy. The most frequently discussed topics concerned the staging of various malignancies, including esophageal, gastric, pancreatic, and colorectal cancer. The average sample size per paper was in the range 25 - 50. The various types of study included retrospective inquiries (25 %), reviews (24 %), prospective studies (17 %), and case reports (15 %). CONCLUSIONS Over the course of the past 20 years, there has been a progressive increase in the number of publications pertaining to endoscopic ultrasonography. Large-scale prospective studies are now needed to validate earlier reports. In addition, the diagnostic and therapeutic role of endoscopic ultrasound needs to be more widely publicized among physicians in all health-care fields, so that appropriate patients may be referred.
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Affiliation(s)
- P Fusaroli
- Dept. of Internal Medicine and Gastroenterology, University of Bologna, Bologna, Italy
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29
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Tucci A, Poli L, Biasco G, Paparo GF, Tosetti C, Fusaroli P, Sambri V, Donati M, Grigioni W, Labate AM, Stanghellini V, Caletti G. Helicobacter pylori infection and gastric function in patients with fundic atrophic gastritis. Dig Dis Sci 2001; 46:1573-83. [PMID: 11478512 DOI: 10.1023/a:1010668727340] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
In the present study we evaluated the relation among histology, H. pylori, IgG to H. pylori, gastric emptying, and acid secretion in 43 patients with fundic atrophic gastritis. On the basis of gastric acid secretion, patients were divided into three subgroups: patients with preserved acid secretion (Group 1), patients with hypochlorhydria (Group 2), and patients with achlorhydria (Group 3). Fundic glandular atrophy was more severe in hypoachlorhydric patients than in those with preserved acid secretion (P < 0.05 vs Group 2, P < 0.005 vs Group 3). H. pylori colonization was found in 94% of patients in Group 1, in 61% of patients in Group 2, and in only 8% of patients in Group 3 (P < 0.001 vs Group 1, P < 0.05 vs Group 2). Conversely, serological positivity to H. pylori was high in all three subgroups of patients (100% in Group 1, 77% in Group 2, 92% in Group 3). Gastric emptying was delayed in atrophic patients, particularly in those with hypoachlorhydria. Our data suggest that fundic atrophic gastritis represents a possible end stage of H. pylori infection, characterized by a progressive disappearance of the bacterium and a progressive deterioration of gastric functions.
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Affiliation(s)
- A Tucci
- Department of Internal Medicine and Gastroenterology, Hospital S. Orsola-Malpighi, University of Bologna, Italy
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30
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31
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Abstract
Twenty years after the introduction of endoscopic ultrasonography, many papers on the topic are still being published every year in the medical literature. Along with established clinical indications, such as gastrointestinal and pancreatic cancer staging and differential diagnosis of submucosal tumors, new applications have been suggested, such as mediastinal and liver tumor sampling with fine-needle aspiration. Improved accuracy and cost-effectiveness have been demonstrated in comparison with other imaging techniques. Reports of large series of fine-needle aspiration procedures have described a high level of accuracy for EUS in the diagnosis of lymph nodes and perivisceral masses. Pancreatic and ampullary tumors still represent a major challenge, as shown by numerous articles describing differential-diagnostic criteria and cytological sampling techniques. A few papers have also been published on the topic of portal hypertension, but it seems questionable whether there is any real advantage for endoscopic ultrasonography over traditional endoscopy here. New techniques such as radiofrequency tumor ablation are promising, while others such as three-dimensional imaging and the use of contrast enhancement have not yet met with routine clinical application. Finally, some of the papers published during the last year have studied the technique of endoscopic ultrasonography itself, dealing with issues of outcome, current clinical availability and use, and the learning curve. Evidently, endoscopic ultrasonography is still widely underused - not only among general practitioners and physicians in other specialties, but even by gastroenterologists. Although endoscopic ultrasonography is already 20 years old, considerable efforts are still needed, therefore, to ensure that it becomes more widely accepted in clinical practice.
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Affiliation(s)
- G Caletti
- Dept. of Internal Medicine and Gastroenterology, S. Orsola Hospital, Bologna, Italy.
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Lambert R, Caletti G, Cho E, Chang KJ, Fusaroli P, Feussner H, Fockens P, Hawes RH, Inui K, Kida M, Lightdale CJ, Matos C, Napoleon B, Palazzo L, Rösch T, Van Dam J. International Workshop on the clinical impact of endoscopic ultrasound in gastroenterology. Endoscopy 2000; 32:549-84. [PMID: 10917190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- R Lambert
- International Agency for Research on Cancer, Lyon, France.
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Abstract
To establish a correct preoperative differential diagnosis between gastric lymphoma and cancer is essential but can be difficult as endoscopic biopsies can sometimes provide a low diagnostic yield. By EUS, infiltrative carcinoma tends to show a vertical growth in the gastric wall, while lymphoma tends to show mainly a horizontal extension. EUS provides an accurate staging of gastric lymphoma, showing the exact level of infiltration and the presence of perigastric lymph nodes, thus the physician can obtain an accurate prognosis for each patient and select the best form of treatment accordingly. The response to chemoradiotherapy can also be investigated very accurately by EUS. Large gastric folds are seen in a great number of benign and malignant conditions. Diagnosis represents a clinical challenge because etiology may be extremely varied and standard biopsies are often inconclusive. Different diseases show different levels of infiltration of the gastric wall, thus a characteristic echo-pattern helps for the differential diagnosis. Endosonography, used always in combination with biopsy, allows to rule out malignancies and to select the most appropriate treatment for each patient (medical or surgical).
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Affiliation(s)
- G Caletti
- Academic Department of Gastroenterology, University of Bologna, Via Massarenti 9, 1-40138, Bologna, Italy.
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Abstract
We describe the case of a young female referred to our unit because of acute upper abdominal symptoms. Upper gastrointestinal endoscopy showed a gastric picture resembling lymphoma or acute non-steroidal anti-inflammatory drug gastropathy (deep, large and irregular ulcers), but the clinical history and the histological examination of gastric biopsies were consistent only with acute gastritis Helicobacter pylori-correlated. The patient was treated with omeprazole and antibiotics with complete recovery. As the patient's cat had suffered from an acute gastrointestinal distress two weeks earlier, a case of zoonosis was hypothesized and an upper gastrointestinal endoscopy was performed also on the cat. Unfortunately, we were not able to detect Helicobacter pylori in the cat gastric mucosa, but only urease-producing spiral microorganisms. Possible sources of infection and pathogenetic mechanisms of the severe gastritis are discussed.
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Affiliation(s)
- G Caletti
- Department of Medicine and Gastroenterology, University of Bologna, Italy.
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Caletti G, Fusaroli P. Endoscopic ultrasonography restaging of oesophageal cancer: linear, radial or nothing? Ital J Gastroenterol Hepatol 1999; 31:598-600. [PMID: 10604100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Affiliation(s)
- G Caletti
- Department of Internal Medicine and Gastroenterology, University of Bologna, Policlinico S. Orsola, Italy.
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Abstract
Areas of application for endosonography can be roughly divided into three categories: standard diagnostic examination; operative diagnostic examination (fine-needle aspiration); and operative therapeutic procedures. Nevertheless, endoscopic ultrasonography remains a single technique, in which the physician can not only raise a suspicion of a particular disease, but can also obtain cytological confirmation when needed and carry out a therapeutic procedure when indicated. Widely accepted indications for endosonography are the staging of esophageal and rectal cancer, and the visualization of submucosal lesions and gastric wall diseases; other indications, such as imaging of the pancreas and biliary tree, are still being discussed.
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Affiliation(s)
- G Caletti
- Dept. of Medicine and Gastroenterology, University of Bologna, Italy.
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39
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Tucci A, Poli L, Tosetti C, Biasco G, Grigioni W, Varoli O, Mazzoni C, Paparo GF, Stanghellini V, Caletti G. Reversal of fundic atrophy after eradication of Helicobacter pylori. Am J Gastroenterol 1998; 93:1425-31. [PMID: 9732919 DOI: 10.1111/j.1572-0241.1998.00454.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVES We sought to evaluate the effect of Helicobacter pylori eradication in patients with fundic atrophic gastritis. METHODS Acid secretion, gastric emptying, and histology were evaluated in 20 patients with fundic atrophic gastritis and H. pylori infection. After investigation, 10 patients (Group 1) received an eradicating treatment and 10 (Group 2) did not receive any treatment. One year later, the baseline investigations were repeated. Subsequently, patients in Group 2 received the same treatment given to patients in Group 1 and were reevaluated 12 months later. A further follow-up was performed in both groups 36 months after the treatment. RESULTS At 1-yr follow-up, all the patients in Group 1 were H. pylori negative whereas all the patients in Group 2 were still infected. In Group 1, there was a significant improvement of both fundic atrophy and acid secretion, compared with baseline (p < 0.01). In Group 2, no substantial modification of either histological or functional parameters was observed at the first follow-up; conversely, a significant (p < 0.01) improvement of fundic atrophy and acid secretion was detected in these patients 12 months after eradication of the bacterium. Histological pattern remained unchanged at 36 months of follow-up in both groups. Gastric emptying remained, on the average, unaffected by the treatment; however, three patients with delayed gastric emptying at entry had normal gastric emptying after eradication of H. pylori. CONCLUSIONS Our data suggest that mucosal atrophy can be reduced or even reversed by the eradication of H. pylori, and this is associated with a recovery of gastric function.
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Affiliation(s)
- A Tucci
- Institute of Medical Clinic & Gastroenterology, Department of Pathology, Hospital S. Orsola-Malpighi, University of Bologna, Italy
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40
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Abstract
Large gastric folds are seen in a great number of benign and malignant conditions. Diagnosis is a clinical challenge because the etiology may be extremely varied and standard biopsies are often inconclusive. The gastric wall is considered thickened at endosonography when it is more than 3.6 mm in width. Different diseases show different levels of infiltration of the gastric wall. When abnormalities involve the second layer only, benign conditions can be considered and standard endoscopic biopsies are often diagnostic. When abnormalities involve layers two and three, different diseases can be suspected, including Helicobacter pylori infection and lymphoma; in this case large-particle biopsy should be considered. When abnormalities involve layer four, malignancy should be strongly suspected even if standard or large-particle biopsies are negative. Endosonography, always in combination with fine-needle or guillotine-needle biopsy, should be able to rule out malignancies and to select the most appropriate treatment for each patient.
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Affiliation(s)
- G Caletti
- Dept. of Medicine and Gastroenterology, University of Bologna, Italy
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41
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Abstract
Endoscopic ultrasonography (EUS) is nowadays a clinically relevant technology and its findings can have a major impact on patient management. This technique is currently indicated for staging digestive cancers, assessment of submucosal tumors, diagnosis of intestinal wall infiltrative diseases, common bile-duct stones and gut neuroendocrine tumors. As far as neoplasms are concerned, EUS appears to be a reliable and safe technique, thus making the physician able to plan either an aggressive surgical treatment, or a conservative palliative therapy. This is of the utmost importance in order to optimize medical-related costs, and to make the best therapeutic decision for each individual patient. EUS is also helpful in monitoring the course of a disease, as it is simple and virtually without complications. When EUS findings are not sufficient for a complete diagnosis, it is now possible to perform an EUS-guided fine-needle biopsy, which can allow a cytological diagnosis. Finally, some therapeutic endosonography-guided procedures are being increasingly adopted, such as cystoenterostomy, celiac plexus neurolysis, cholangio-pancreatography and selective injection of botulinum toxin in the muscle layer of the lower esophageal sphincter.
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Affiliation(s)
- G Caletti
- Department of Medicine and Gastroenterology, University of Bologna, Italy.
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42
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Caletti G, Bocus P, Fusaroli P, Togliani T, Marhefka G, Roda E. Cancer of the esophagus--endoscopic ultrasound: selection for cure. Can J Gastroenterol 1998; 12:341-6. [PMID: 9773213 DOI: 10.1155/1998/535370] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Several treatment options are available to treat esophageal cancer. Ideally, treatment should be individualized, based on the projected treatment outcome for that individual. Accurate staging of the extent of the disease at the time of diagnosis offers the most rational attempt at stratifying patients into categories that can be used to affect treatment choices. Endoscopic ultrasonography (EUS) is the most accurate nonoperative technique for determining the depth of tumour infiltration and thus is accurate in predicting which patients will be able to undergo complete resection. EUS is also being used for tumour staging in order to guide treatment decisions in patients with esophageal cancer.
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Affiliation(s)
- G Caletti
- Department of Medicine and Gastroenterology, University of Bologna, Italy.
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Tucci A, Poli L, Paparo GF, Bocus P, Togliani T, Mazzoni C, Orcioni GF, Agosti R, Grigioni WF, Sottili S, Caletti G. Weekend therapy for the treatment of Helicobacter pylori infection. Am J Gastroenterol 1998; 93:737-42. [PMID: 9625119 DOI: 10.1111/j.1572-0241.1998.216_a.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The aim of the present study was to evaluate the efficacy and the safety of a short-term regimen (weekend therapy) in the cure of Helicobacter pylori infection and to analyze the factors that may influence the success of the treatment. METHODS Seventy-one patients with gastric colonization by a tinidazole sensitive H. pylori strain (34 duodenal ulcer and 37 nonulcer dyspepsia) received omeprazole 40 mg o.m. for 7 days (from Monday to Sunday) and bismuth 240 mg q.i.d. + amoxicillin 1000 mg/q.i.d. + tinidazole 500 mg q.i.d. for only 2 days (Saturday and Sunday). Endoscopy, histology, culture, urease test, and susceptibility studies were done at entry and 30 days after treatment. RESULTS Successful eradication was obtained in 84% of patients. The percentage of eradication was higher in duodenal ulcer patients (94%) than in those with nonulcer dyspepsia (74%; p < 0.05), and in patients who received the treatment during hot weather (94%) than in those who received the treatment during cold weather (74%; p < 0.05). Side-effects were induced by the treatment in 17% of patients, and these were all not severe, self-limiting, short-lasting, and did not require specific treatment. CONCLUSIONS These data suggested that weekend therapy with high doses of drugs represents an effective, safe, and inexpensive therapeutic approach for the treatment of H. pylori infection, particularly in patients with duodenal ulcer. Furthermore, they also confirm the relevant role that short-term treatments may play in the therapeutic approach to H. pylori infection, and highlight some important aspects influencing short-term schedules.
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Affiliation(s)
- A Tucci
- The Institute of Medical Clinic and Gastroenterology, Department of Pathology, Hospital S. Orsola-Malpighi, University of Bologna, Italy
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Affiliation(s)
- G Caletti
- Dept. of Medicine and Gastroenterology, University of Bologna, Italy.
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Caletti G, Deviere J, Fockens P, Lees WR, Mortensen B, Odegaard S, Rösch T, Souquet JS, Vilmann P. Guidelines of the European Society of Gastrointestinal Endoscopy (ESGE) Part II: Retroperitoneum and large bowel, training. The European Endosonography Club Working Party. Endoscopy 1996; 28:626-8. [PMID: 8911809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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Tucci A, Poli L, Donati M, Mazzoni C, Cevenini R, Sambri V, Varoli O, Bocus P, Ferrari A, Paparo GF, Caletti G. Value of serology (ELISA) for the diagnosis of Helicobacter pylori infection: evaluation in patients attending endoscopy and in those with fundic atrophic gastritis. THE ITALIAN JOURNAL OF GASTROENTEROLOGY 1996; 28:371-6. [PMID: 8937937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
In the present study we assessed the diagnostic accuracy of four commercial IgG enzyme-linked immunosorbent assay (ELISA) kits (Autoplate, H.pylori-EIA-Well, Enzygnost, Helori-test) and evaluated the performance of these tests in patients with fundic atrophic gastritis. Serum antibodies to Helicobacter pylori were measured in 70 out-patients attending endoscopy for dyspepsia and 43 patients with non-autoimmune fundic atrophic gastritis. Using the cut-off values recommended by the manufacturers, and comparing serological findings with gastric biopsy results of dyspeptic out-patients attending endoscopy, the four kits showed a sensitivity and specificity, respectively, of 91% and 96%, for Autoplate, 67% and 100% for H.pylori-EIA-Well, 79% and 100% for Enzygnost, and 81% and 96% for Helori-test. Evaluation in patients with atrophic gastritis revealed a high prevalence of antibodies to Helicobacter pylori (84%) and it demonstrated that patients with and those without gastric colonization by this microorganism had a similar rate of seropositivity (76-84% vs 50-78%). In conclusion, our data demonstrate that: a) this assay is a reliable and valid method to detect gastric colonization by Helicobacter pylori; b) positive serum antibody associated with a negative detection of Helicobacter pylori in the gastric mucosa suggests mucosal atrophy; c) patients with fundic atrophic gastritis should be excluded from studies investigating the value of serology in diagnosing Helicobacter pylori infection.
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Affiliation(s)
- A Tucci
- Istituto di Clinica Medica e Gastroenterologia, Università di Bologna, Italy
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Gandolfi L, Colecchia A, Leo P, Caletti G, Rossi A, Primerano A, Torresan F. Endoscopic ultrasonography in the diagnosis of gastrointestinal amyloid deposits: clinical case report. Endoscopy 1995; 27:132-4. [PMID: 7601026 DOI: 10.1055/s-2007-1005648] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
A case of systemic amyloidosis of the digestive tract is described here, with particular attention to the endoscopic ultrasonography aspects, characterized by a wide-spread thickening of the stomach and rectum walls, with loss of the normal layer structure of the mucosa and submucosa. Endoscopic ultrasonography, especially in pseudotumoral forms, may contribute to the differential diagnosis from neoplastic lesions, in which the wall thickening appears to be localized and accompanied by parietal infiltration.
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Affiliation(s)
- L Gandolfi
- Section of Gastroenterology, Sant'Orsola-Malpighi Polyclinic Hospital, Bologna, Italy
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Caletti G, Odegaard S, Rösch T, Sivak MV, Tio TL, Yasuda K. Endoscopic ultrasonography (EUS): a summary of the conclusions of the Working Party for the Tenth World Congress of Gastroenterology Los Angeles, California October, 1994. The Working Group on Endoscopic Ultrasonography. Am J Gastroenterol 1994; 89:S138-43. [PMID: 8048404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Caletti G, Ferrari A, Brocchi E, Barbara L. Accuracy of endoscopic ultrasonography in the diagnosis and staging of gastric cancer and lymphoma. Surgery 1993; 113:14-27. [PMID: 8417483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND There is a need to assess the sensitivity, specificity, and predictive value of endoscopic ultrasonography (EUS) in the diagnosis and staging of gastric cancer and lymphoma. METHODS A prospective study was performed on 86 patients with endoscopic gross appearance suspicious for cancer or lymphoma. Biopsies with endoscopic forceps were always carried out before EUS. All patients underwent laparotomy for final diagnosis, staging, and eventually treatment. The results of EUS were correlated with the histologic findings of the resected specimens, when possible, or with the surgical findings. There were 42 gastric cancers and 44 primary gastric lymphomas. RESULTS EUS made a correct diagnosis of cancer in 35 of 42 patients, with a sensitivity of 83%. Positive predictability was 87%, specificity was 97%, and negative predictability was 96%. Diagnostic accuracy was 95%. In the evaluation of cancer depth invasion, EUS was correct in 91% of cases. EUS displayed perigastric metastatic lymph nodes in 14 of 25 patients, with a sensitivity of 56%. Positive predictive value was 93%, specificity was 93%, and negative predictive value was 54%. Diagnostic accuracy was 69%. EUS made a correct diagnosis of lymphoma in 39 of 44 patients, with a sensitivity of 89%. Positive predictability was 87%, specificity was 97%, and negative predictability was 97%. Diagnostic accuracy was 95%. In the evaluation of lymphoma depth invasion, EUS was correct in 92% of cases. EUS displayed metastatic perigastric lymph nodes in 8 of 18 patients, with a sensitivity of 44%. Positive predictability was 100%, specificity was 100%, and negative predictability was 72%. Diagnostic accuracy was 77%. CONCLUSIONS From these data it appears that in these diseases EUS has demonstrated specific ultrasonographic features that allow correct diagnosis and staging in the majority of patients. In difficult cases EUS may help to achieve the correct diagnosis. EUS also appear to be a useful tool for staging of gastric cancer and lymphoma. It shows not only tumor depth and local spread but also the passage from a pathologic to a normal wall and lymph node metastasis. With this accurate noninvasive staging procedure, in the near future many patients will no longer undergo exploratory laparotomy for surgical staging. Thanks to EUS, the choice of conservative or surgical treatment can be strongly affected. In case of surgery, EUS can orient the kind of surgical approach. Moreover, the use of EUS for evaluation of therapy during follow-up will probably become of major importance.
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Affiliation(s)
- G Caletti
- Academic Department of Medicine, University of Bologna, Italy
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