Search Results for: La sindrome del colon irritabile

Circulation, Volume 148, Issue Suppl_1, Page A12582-A12582, November 6, 2023. Introduction:Cardiovascular disease and cancer have previously been linked to share similar pathophysiological pathways, although these two entities are rarely studied in congruence.Method:We analyzed the 2019 National Readmission Database (NRD) and used unsupervised learning and K-means clustering for data analysis. We employed the Shapley Additive Explanation (SHAP) model to explain which features contribute the most to clustering. The final cohort was divided into four clusters guided by the Elbow method. Continuous variables were analyzed with Kruskal-Wallis test and reported as medians and interquartile ranges (IQR) after checking for normality test. We also performed sensitivity analysis on patients with cancer without applying a Boruta algorithm.Results:The final cohort includes 297,597 patients, and we randomly sampled 100,000 patients within divided into 4 clusters. The most prevalent types of cancer in clusters 1 were brain cancer (15%), prostate cancer (9.4%), non-Hodgkin’s lymphoma (8.7%), lung cancer (8.6%), and other specified and unspecified types of non-Hodgkin’s lymphoma (7.8%). Most prevalent cancers in cluster 2 were lung cancer (13.1%), prostate cancer (11.6%), breast cancer (8.5%), colon cancer (7.9%), and kidney cancer (5.5%). In cluster 3, lung cancer (15.6%), prostate cancer (9.3%), multiple myeloma (8.9%), lymphoid leukemia (7.6%), and other specified and unspecified types of non-Hodgkin’s lymphoma were more prevalent. Furthermore, in cluster 4, myeloid leukemia (27.7%), non-Hodgkin’s lymphoma (20.1%), multiple myeloma (14.8%), lymphoid leukemia (12.4%), and other specified and unspecified types of non-Hodgkin’s lymphoma (10.4%) were the most prevalent cancers. Patients grouped in Cluster 3 had higher percentages of cardiovascular risk factors and comorbidities such as hypertension, diabetes, hyperlipidemia, kidney diseases, and pulmonary hypertension. Cardiovascular outcomes were naturally more frequent in cluster 3.Conclusion:Although cardiovascular disease and cancer have previously been linked to share pathophysiology, our study emphasizes that commonality between two seemingly different diseases may all be secondary to shared underlying cardiovascular risk factors.

Circulation, Volume 148, Issue Suppl_1, Page A16391-A16391, November 6, 2023. Background:Heart diseases are associated with an increased incidence of cancer independently of shared risk factors. The mechanism beyond this link is complex, unclear and limits our ability to develop effective therapies. We aimed to test the hypothesis that small cardiac extracellular vesicles (sEVs) contribute to the link between HF and cancer.Methods & Results:We used mouse models of heterotopic and orthotopic lung cancer and post-myocardial infarction (MI) heart failure (HF). sEVs were isolated by size exclusion chromatography. To determine the role of cardiac EVs in tumor growth, we focused on sEVs from cardiac mesenchymal stromal cells (cMSCs). cMSCs after MI secreted twice more sEVs, characterized with a unique proteome, compared with cMSCs from sham-MI (Fig 1A). cMSC-sEVs from post-MI HF harbored more tumor-promoting cytokines and microRNA (miR), such as periostin, osteopontin, IL-6, TNFα, galectin-3, and miR’s 221 and 21. The pro-neoplastic effects of cMSC-sEVs on cancer cells were depended on cancer type, with a marked increase in proliferation and migration of lung and colon cancer cells but only a modest increase with more malignant triple-negative breast and melanoma cancer cells. Next, we inoculated lung cancer cells into mice and found that post-MI HF accelerated tumor growth. Furthermore, adoptive transfer of cMSC-sEVs from failing hearts accelerated tumor growth with and without systemic EV depletion (Fig 1B). Finally, we found that spironolactone mitigated the neoplastic effects of HF, attenuated tumor growth (Fig 1C), and reduced the number of cMSC-sEVs by 26%.Conclusions:We show, for the first time, that cardiac extracellular vesicles from post-MI failing heart harbor pro-neoplastic properties and promote tumor growth independently of other secreted factors. Spironolactone reduces the number of cardiac extracellular vesicles and the pro-neoplastic effects of post-MI heart failure.

Circulation, Volume 148, Issue Suppl_1, Page A14764-A14764, November 6, 2023. Background:Sudden death accounts for approximately 10% of deaths among working age adults. The rate of sudden death among females is one third lower than males, although the burden of chronic medical conditions are similar in victims of both sexes. The reasons for this difference are unclear and may be important in addressing preventive screening underutilization, as preventive screenings have been shown to reduce morbidity and mortality.Research Questions:Does utilization of preventive services differ among sudden death victims and living controls? Do these differences vary by sex?Aims:We aim to describe receipt of preventive screenings and influenza vaccination in sudden death victims and to compare these rates to those of a living control population.Methods:Clinical records from 267 out-of-hospital sudden death victims aged 18-64 in Wake County, North Carolina from 2013-2015 and 1112 demographically matched living controls from the same county and time were compared. Victims were identified by screening Emergency Medical Service records and adjudicated to exclude expected deaths from chronic disease, trauma, suicide, and overdose. Records were systematically reviewed for evidence of influenza vaccination and receipt of colon, cervical, and breast cancer screenings within the past five years, according to USPSTF criteria. Percentage of individuals who received each preventive screening were compared using means difference tests. Binomial regression was performed to investigate the effect of insurance status on preventive care receiptResults:Rates of colonoscopy and influenza vaccination were similar between cases and controls among both sexes. Female victims had low utilization of preventive services and were less likely to have received Pap smears (24.1% vs 50.9%; p

Circulation, Volume 148, Issue Suppl_1, Page A14540-A14540, November 6, 2023. Introduction:Cardiovascular disease (CVD) and cancer share a common risk factor: chronic toxic stress/allostatic load (AL). Our previous research found that a 1-point increase in AL is linked to a 25-30% higher risk of major cardiac events (MACE) in prostate cancer patients.Hypothesis:Higher AL is associated with increased MACE risk in patients with breast, lung, and colon cancer.Methods:Patients ≥18 years diagnosed for the first time with the mentioned 3 cancers of interest between 2010-2019 at a large, hybrid academic-community practice were included in this retrospective cohort study. AL was modeled as an ordinal measure (0-11;Table 1). Adjusted Fine-Gray Cox proportional hazard regressions estimated the impact of AL pre- and 60 days post- cancer diagnosis on 2-year MACE.Results:Demographic characteristics are summarized in Table 1. Two-year mace MACE occurred in 12.3%, 23.3%, and 9.7% of breast, lung, and colon cancer patients, respectively. Heart failure was the most common MACE, observed in 7.9%, 14.4%, and 4.8% of breast, lung, and colon cancer patients, respectively. Before cancer diagnosis, a 1-point increase in AL raised MACE risk by 11% (aHR=1.11, 95% CI 1.07-1.16) in breast cancer, 18% (aHR=1.18, 95% CI 1.11-1.25) in lung cancer, and 9% (aHR=1.09, 95% CI 1.01-1.18) in colon cancer. After cancer diagnosis, a 1-point increase in AL increased MACE risk by 10% (aHR=1.10, 95% CI 1.06-1.15) in breast cancer and 19% (aHR=1.19, 95% CI 1.12-1.25) in lung cancer, but was not statistically significant in colon cancer (aHR=1.07, 95% CI 0.99-1.16).Conclusion(s):Higher AL levels prior to breast, lung, and colon cancer diagnoses are associated with increased MACE risk. Thus, effective implementation of patient-centered communication considering stress levels, stressors, and coping mechanisms is necessary during cardiovascular screening for these cancer patients. Further prospective studies are needed.

Circulation, Volume 148, Issue Suppl_1, Page A16014-A16014, November 6, 2023. Background:People with heart failure (HF) experience impaired physical and mental health. However, health-related quality of life (HRQOL) in people with HF to those with cancer, another condition that impacts HRQOL, have not been directly compared in a contemporary population.Research Question:How does HRQOL compare in people with HF to those with lung, colon, breast, or prostate cancer?Methods:We performed a pooled analysis of Medicare Health Outcomes Survey data between 2016-2020 in participants ≥65 years with a self-reported history of HF or active treatment for lung, colon, breast, or prostate cancer using two HRQOL measures. The Veterans RAND-12 generates the physical component score (PCS) and mental component score (MCS), which range from 0-100 with a mean score of 50 (based on general US population), a standard deviation of 10, and a lower score representing worse health. We used pairwise t-tests to evaluate for differences in PCS and MCS by group. We used chi-squared to compare the distribution of days with poor physical or mental health in the past 30 days as measured by CDC Healthy Days core questions.Results:Compared to participants with lung, colon, breast, or prostate cancer, participants with HF (n=71,025; 54% female, 16% Black) had lower mean PCS and MCS (Figure; P

La sindrome di Chops, genitori hanno dato via a Fondazione

Esperta, ‘serve una strategia di prevenzione. Cruciali dieta e movimento’

The purpose of this American Gastroenterological Association (AGA) Institute Clinical Practice Update (CPU) is to review the available evidence and provide expert commentary on the current landscape of artificial intelligence in the evaluation and management of colorectal polyps.

Objectives
To explore the relationship between immigration groups and cancer mortality, this study aimed to explore age, period, birth cohort effects and effects across genders and immigration groups on mortality rates of lung, pancreatic, colon, liver, prostate and stomach cancers and their projections.

Design, setting, and participants
Death registry data in Hong Kong between 1998 and 2021, which were stratified by age, sex and immigration status. Immigration status was classified into three groups: locals born in Hong Kong, long-stay immigrants and short-stay immigrants.

Methods
Age-period-cohort (APC) analysis was used to examine age, period, and birth cohort effects for genders and immigration groups from 1998 to 2021. Bayesian APC models were applied to predict the mortality rates from 2022 to 2030.

Results
Short-stay immigrants revealed pronounced fluctuations of mortality rates by age and of relative risks by cohort and period effects for six types of cancers than those of long-stay immigrants and locals. Immigrants for each type of cancer and gender will be at a higher mortality risk than locals. After 2021, decreasing trends (p0.05) of forecasting mortality rates of cancers occur for all immigration groups, except for increasing trends for short-stay male immigrants with colon cancer (p

Sindrome da attivazione macrofagica, studio clinico Bambin Gesù

Da un libro di Cinthia Caruso, ancora tanto da scoprire

Introduction
Follow-up after an episode of colonic diverticulitis is a common indication for colonoscopy, even though studies have shown a low risk of positive findings in this population. Our objective is to investigate colon capsule endoscopy (CCE) as a follow-up examination in patients with colonic diverticulitis compared with colonoscopy, particularly regarding patient satisfaction and clinical performance.

Methods and analysis
We will conduct a single-centre prospective randomised controlled trial. Patients seen at Odense University Hospital with acute diverticulitis confirmed by CT will be included and randomised to either follow-up by colonoscopy or CCE. Detection of suspected cancer, more than two polyps or any number of polyps larger than 9 mm in CCE will generate an invitation to a diagnostic colonoscopy for biopsies or polyp removal. We will compare colonoscopy and CCE regarding patient satisfaction and tolerance, the number of complete examinations, the number of patients referred to a subsequent colonoscopy after CCE and the prevalence of diverticula, polyps, cancers and other abnormal findings.

Ethics and dissemination
Informed consent will be obtained from all participants before randomisation. The study was approved by the regional ethics committee (ref. S-20210127) and the Danish Data Protection Agency (ref. 22/43235). After completion of the trial, we plan to publish two articles in high-impact journals. One article on both primary and secondary outcomes.

Trial registration number
NCT05700981.

IL-3 has been reported to be involved in various inflammatory disorders, but its role in inflammatory bowel disease (IBD) has not been addressed so far. Here, we determined IL-3 expression in samples from patients with IBD and studied the impact of Il3 or Il3r deficiency on T cell-dependent experimental colitis. We explored the mechanical, cytoskeletal and migratory properties of Il3r –/– and Il3r +/+ T cells using real-time deformability cytometry, atomic force microscopy, scanning electron microscopy, fluorescence recovery after photobleaching and in vitro and in vivo cell trafficking assays. We observed that, in patients with IBD, the levels of IL-3 in the inflamed mucosa were increased. In vivo, experimental chronic colitis on T cell transfer was exacerbated in the absence of Il-3 or Il-3r signalling. This was attributable to Il-3r signalling-induced changes in kinase phosphorylation and actin cytoskeleton structure, resulting in increased mechanical deformability and enhanced egress of Tregs from the inflamed colon mucosa. Similarly, IL-3 controlled mechanobiology in human Tregs and was associated with increased mucosal Treg abundance in patients with IBD. Collectively, our data reveal that IL-3 signaling exerts an important regulatory role at the interface of biophysical and migratory T cell features in intestinal inflammation and suggest that this might be an interesting target for future intervention.

Message Guideline-conforming endoscopic polyp resection and follow-up are dependent on accurate polyp sizing estimation. However, studies evaluating the feasibility and accuracy of pathology-based polyp size measurement are lacking. We conducted a prospective clinical study (482 polyps resected in 203 consecutive patients) evaluating pathology-based size measurement for colorectal polyps. To obtain reference size measurements, we measured polyp size immediately after removing polyps from the colon prior to formalin fixation. Due to piecemeal resection or fragmentation of specimens during the retrieval process, only 59% of resected polyps could actually be evaluated histologically for size. The estimated mean polyp shrinkage because of formalin fixation was 26% which resulted in 33% of polyps ≥10 mm pre-fixation being miscategorised as