scholarly journals Hyperplastic polyp or sessile serrated lesion? The contribution of serial sections to reclassification

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Diana R. Jaravaza ◽  
Jonathan M. Rigby
Keyword(s):  
Potential Role ◽  
Hyperplastic Polyp ◽  
Fragment Size ◽  
World Health ◽  
Serial Sections ◽  
Hyperplastic Polyps ◽  
Serrated Polyps ◽  
Serrated Lesions ◽  
Serrated Lesion ◽  
Health Organization

Abstract Background The histological discrimination of hyperplastic polyps from sessile serrated lesions can be difficult. Sessile serrated lesions and hyperplastic polyps are types of serrated polyps which confer different malignancy risks, and surveillance intervals, and are sometimes difficult to discriminate. Our aim was to reclassify previously diagnosed hyperplastic polyps as sessile serrated lesions or confirmed hyperplastic polyps, using additional serial sections. Methods Clinicopathological data for all colorectal hyperplastic polyps diagnosed in 2016 and 2017 was collected. The slides were reviewed and classified as hyperplastic polyps, sessile serrated lesion, or other, using current World Health Organization criteria. Eight additional serial sections were performed for the confirmed hyperplastic polyp group and reviewed. Results Of an initial 147 hyperplastic polyps from 93 patients, 9 (6.1%) were classified as sessile serrated lesions, 103 as hyperplastic polyps, and 35 as other. Of the 103 confirmed hyperplastic polyps, 7 (6.8%) were proximal, and 8 (7.8%) had a largest fragment size of ≥5 mm and < 10 mm. After 8 additional serial sections, 11 (10.7%) were reclassified as sessile serrated lesions. They were all less than 5 mm and represented 14.3% of proximal polyps and 10.4% of distal polyps. An average of 3.6 serial sections were required for a change in diagnosis. Conclusion Histopathological distinction between hyperplastic polyps and sessile serrated lesions remains a challenge. This study has uncovered a potential role for the use of additional serial sections in the morphological reappraisal of small hyperplastic polyps, especially when proximally located.

scholarly journals Evaluation of the first pharmacy-led weight management programme in Greece

2021 ◽  
Vol 29 (Supplement_1) ◽  
pp. i45-i46
Author(s):  
A Peletidi ◽  
R Kayyali
Keyword(s):  
Public Health ◽  
Health Services ◽  
Potential Role ◽  
Annual Report ◽  
World Health ◽  
Public Health Services ◽  
Cvd Risk ◽  
The World ◽  
Health Organization

Abstract Introduction Obesity is one of the main cardiovascular disease (CVD) risk factors.(1) In primary care, pharmacists are in a unique position to offer weight management (WM) interventions. Greece is the European country with the highest number of pharmacies (84.06 pharmacies per 100,000 citizens).(2) The UK was chosen as a reference country, because of the structured public health services offered, the local knowledge and because it was considered to be the closest country to Greece geographically, unlike Australia and Canada, where there is also evidence confirming the potential role of pharmacists in WM. Aim To design and evaluate a 10-week WM programme offered by trained pharmacists in Patras. Methods This WM programme was a step ahead of other interventions worldwide as apart from the usual measuring parameters (weight, body mass index, waist circumference, blood pressure (BP)) it also offered an AUDIT-C and Mediterranean diet score tests. Results In total,117 individuals participated. Of those, 97.4% (n=114), achieved the programme’s aim, losing at least 5% of their initial weight. The mean % of total weight loss (10th week) was 8.97% (SD2.65), and the t-test showed statistically significant results (P&lt;0.001; 95% CI [8.48, 9.45]). The programme also helped participants to reduce their waist-to-height ratio, an early indicator of the CVD risk in both male (P=0.004) and female (P&lt;0.001) participants. Additionally, it improved participants’ BP, AUDIT-C score and physical activity levels significantly (P&lt;0.001). Conclusion The research is the first systematic effort in Greece to initiate and explore the potential role of pharmacists in public health. The successful results of this WM programme constitute a first step towards the structured incorporation of pharmacists in public’s health promotion. It proposed a model for effectively delivering public health services in Greece. This study adds to the evidence in relation to pharmacists’ CVD role in public health with outcomes that superseded other pharmacy-led WM programmes. It also provides the first evidence that Greek pharmacists have the potential to play an important role within primary healthcare and that after training they are able to provide public health services for both the public’s benefit and their clinical role enhancement. This primary evidence should support the Panhellenic Pharmaceutical Association, to “fight” for their rights for an active role in primary care. In terms of limitations, it must be noted that the participants’ collected data were recorded by pharmacists, and the analysis therefore depended on the accuracy of the recorded data, in particular on the measurements or calculations obtained. Although the sample size was achieved, it can be argued that it is small for the generalisation of findings across Greece. Therefore, the WM programme should be offered in other Greek cities to identify if similar results can be replicated, so as to consolidate the contribution of pharmacists in promoting public health. Additionally, the study was limited as it did not include a control group. Despite the limitations, our findings provide a model for a pharmacy-led public health programme revolving around WM that can be used as a model for services in the future. References 1. Mendis S, Puska P, Norrving B, World Health Organization., World Heart Federation., World Stroke Organization. Global atlas on cardiovascular disease prevention and control [Internet]. Geneva: World Health Organization in collaboration with the World Heart Federation and the World Stroke Organization; 2011 [cited 2018 Jun 26]. 155 p. Available from: http://www.who.int/cardiovascular_diseases/publications/atlas_cvd/en/ 2. Pharmaceutical Group of the European Union. Pharmacy with you throughout life:PGEU Annual Report [Internet]. 2015. Available from: https://www.pgeu.eu/en/library/530:annual-report-2015.html

scholarly journals Morphological Characteristics, Classifications and Difficulties in the Use of Diagnostic Criteria for Serrated Lesions of the Large Intestine

2021 ◽  
Author(s):  
Cesar de Souza Bastos Junior ◽  
Vera Lucia Nunes Pannain ◽  
Adriana Caroli-Bottino
Keyword(s):  
Diagnostic Criteria ◽  
Morphological Characteristics ◽  
World Health ◽  
Diagnostic Tools ◽  
Serrated Adenoma ◽  
The Past ◽  
The World ◽  
Serrated Lesions ◽  
Health Organization

Abstract Introduction Colorectal carcinoma (CRC) is the most common gastrointestinal neoplasm in the world, accounting for 15% of cancer-related deaths. This condition is related to different molecular pathways, among them the recently described serrated pathway, whose characteristic entities, serrated lesions, have undergone important changes in their names and diagnostic criteria in the past thirty years. The multiplicity of denominations and criteria over the last years may be responsible for the low interobserver concordance (IOC) described in the literature. Objectives The present study aims to describe the evolution in classification of serrated lesions, based on the last three publications of the World Health Organization (WHO) and the reproducibility of these criteria by pathologists, based on the evaluation of the IOC. Methods A search was conducted in the PubMed, ResearchGate and Portal Capes databases, with the following terms: sessile serrated lesion; serrated lesions; serrated adenoma; interobserver concordance; and reproducibility. Articles published since 1990 were researched. Results and Discussion The classification of serrated lesions in the past thirty years showed different denominations and diagnostic criteria. The reproducibility and IOC of these criteria in the literature, based on the kappa coefficient, varied in most studies, from very poor to moderate. Conclusions Interobserver concordance and the reproducibility of microscopic criteria may represent a limitation for the diagnosis and appropriate management of these lesions. It is necessary to investigate diagnostic tools to improve the performance of the pathologist's evaluation, for better concordance, and, consequently, adequate diagnosis and treatment.

scholarly journals Lung ultrasound in COVID-19: a useful diagnostic tool

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Gianmarco Secco ◽  
Marzia Delorenzo ◽  
Caterina Zattera ◽  
Bianca Giacomuzzi Moore ◽  
Lorenzo Demitry ◽  
...  
Keyword(s):  
Potential Role ◽  
Lung Ultrasound ◽  
Short Review ◽  
World Health ◽  
Emergency Setting ◽  
Inherent Risk ◽  
Therapeutic Protocols ◽  
Health Organization

Coronavirus disease 2019 (Covid-19), caused by a novel enveloped RNA betacoronavirus, has recently been declared a public health emergency by the World Health Organization (WHO). The lack of knowledge at the beginning of the pandemics, associated with the inherent risk of infective spreading, makes initial recognition and management particularly complex, in terms of defining effective diagnostic and therapeutic protocols. In the Emergency setting, Lung Ultrasound (LUS) can play an important role in the management of patients with SARS-CoV2-related pneumonia, expanding from the initial diagnosis to the subsequent monitoring and follow-up. Among many other potential advantages (such has the absence of ionizing radiation, its inherent costeffectiveness, and bedside repeatability), LUS provides immediate diagnostic response and might prevent the risk of spreading the infection by moving the patient from the Emergency Room to the Radiology facilities. Aim of this short review is to define the potential role of lung ultrasound in Covid-19 patients, according to the evidence in the medical literature

Somatic targeted mutation profiling of colorectal cancer precursor lesions

2021 ◽  
Author(s):  
Wellington dos Santos ◽  
Mariana Bisarro dos Reis ◽  
Jun Porto ◽  
Ana Carolina de Carvalho ◽  
Marcus Matsushita ◽  
...  
Keyword(s):  
Driver Mutations ◽  
Precursor Lesions ◽  
Hyperplastic Polyps ◽  
Serrated Polyps ◽  
Targeted Mutation ◽  
Mutation Profile ◽  
Serrated Lesions ◽  
Advanced Adenomas ◽  
Biological History ◽  
High Degree

Abstract Most colorectal cancers (CRC) arise from precursor lesions. We aimed to characterize the mutation profile of CRC precursor lesions in a Brazilian population. In total, 90 FFPE lesions, including 67 adenomas, 7 sessile serrated lesions, and 16 hyperplastic polyps, were analyzed by next-generation sequencing. The genetic ancestry of the patients was estimated. Somatic driver mutations were identified in 66.7% of cases, including alterations in APC (32.2%), TP53 (20.0%), KRAS (18.9%), BRAF (13.3%) and EGFR (7.8%). Adenomas displayed a higher number of mutations, mainly in APC, compared to serrated polyps (73.1% vs. 47.8%, p = 0.039). Advanced adenomas had a higher frequency of mutation in KRAS and GNAS and a high overall mutation rate than early adenomas (92.9% vs. 59%, p = 0.002). Concerning the serrated pathway, a higher frequency of mutations, mainly in BRAF, was observed in sessile serrated lesions (85.7%) compared to hyperplastic polyps (31.3%, p = 0.027). A high degree of ancestry admixture was observed in the population, with a predominance of European followed by African components. The mutation profile of Brazilian colorectal precursor lesions exhibits a similar landscape to other populations. These results bestow the knowledge of CRC's biological history and may contribute to a molecular screening approach.

scholarly journals Hyperplastic Polyp? Look Again... The Impact of the New Classification for Serrated Polyps

2014 ◽  
Vol 27 (3) ◽  
pp. 304 ◽  
Author(s):  
Catarina Fidalgo ◽  
Liliana Santos ◽  
Isadora Rosa ◽  
Ricardo Fonseca ◽  
Pedro Lage ◽  
...  
Keyword(s):  
World Health Organization ◽  
Colonic Polyps ◽  
World Health ◽  
Hyperplastic Polyps ◽  
Sessile Serrated Adenoma ◽  
Serrated Adenoma ◽  
World Health Organization Classification ◽  
Health Organization ◽  
The Impact ◽  
Serrated Adenomas

<p><span style="font-family: Times New Roman; font-size: small;"><strong>Introduction:</strong> The World Health Organization reviewed the classification for serrated colonic polyps in 2010. A new entity, sessile serrated adenoma, was included with two variants: with and without cytological dysplasia. This lesion’s malignant potential has been recognized and according to the new classification, many polyps may be reclassified. The impact of this change is yet to be assessed.<br /><strong>Objective:</strong> Analyze the proportion of lesions that were reclassified according to the new World Health Organization classification and the variables that influenced it.<br /><strong>Material and Methods:</strong> Every patient with at least one sessile serrated adenoma diagnosed in a 5 year period was included. All polyps (regardless of type) resected during the study period were reviewed. Data concerning polyp’s characteristics and patient variables were collected. Forty consecutive patients were included [13 female, mean age at 1st sessile serrated adenoma -59 yrs (34-80)].<br /><strong>Results:</strong> Were reviewed 247 polyps: hyperplastic - 42%; conventional adenomas - 29%; sessile serrated adenoma - 24%; serrated adenomas - 5%. Sixty-three polyps were reclassified: 43 hyperplastic, 12 serrated adenomas, 7 sessile serrated adenoma and 1 conventional adenoma with low grade dysplasia. Reclassification was significantly greater for hyperplastic polyps when compared with the other subtypes. Forty-three of one hundred and four (41%) hyperplastic polyps were reclassified all as sessile serrated adenoma. In these polyps the probability of reclassification was independent from polyp location but was greater if polyp size ≥ 5 mm.<br /><strong>Discussion: </strong>This is a single center, rectrospective study. The fact that it was done in an Oncology Referral Institution with a Family Risk Clinic may have influenced the results. Nevertheless the impressive reclassification rate for Hyperplastic Polyps and the fact that they were reclassified mainly as Serrated Adenomas makes these results relevant to daily practice.<br /><strong>Conclusion:</strong> Our results suggest that, according to the new World Health Organization classification for serrated colonic polyps, a considerable proportion of hyperplastic polyps will be reclassified. The serrated pathway of colorectal carcinogenesis has probably been underestimated and at-risk patients may have been under inappropriate surveillance.<br /><strong>Keywords: </strong>Colonic Neoplasms/diagnosis; Colonic Polyps/classification; World Health Organization; Neoplasm Grading.</span></p>

scholarly journals POTENTIAL ROLE OF CURCUMIN AS A TREATMENT OPTION FOR COVID-19: A REVIEW

2021 ◽  
Vol 21 (no 1) ◽  
Author(s):  
Md Sadique Hussain
Keyword(s):  
Potential Role ◽  
Curcuma Longa ◽  
World Health ◽  
Treatment Modalities ◽  
Therapeutic Effects ◽  
Viral Binding ◽  
Therapeutic Properties ◽  
Health Organization ◽  
Symptoms And Signs

Severe Acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes CoV disease 2019 (COVID-19) which is presently a pandemic declared by world health organization. Treatment modalities for this disease are being explored. Curcumin the phytoconstituent of Curcuma longa, can be a potential treatment for COVID-19 because various findings suggest its therapeutic properties like antioxidant, antiemetic, antifatigue effects which can potentially manage symptoms and signs of COVID-19, also it has antiviral properties such as impeding the viral binding to host cell as well as replication. It has restrictive actions on viral protease as well and having inhibitory actions on pro-inflammatory cytokine molecules.Thus, it alleviates symptoms due to inflammation such as fibrosis and edema in pulmonary region. Broncho dilatory effects of curcumin as well as suppression of cough via acting on bradykinin thus curcumin can alleviate symptoms such as cough in COVID-19 sufferers. Curcumin also has preventive actionson Cardiovascular and renal damage due to COVID-19. All these potential activities suggest the possible use of curcumin in management of COVID-19. Clinical studies should be considered to explore the same. In this review we highlight the potential therapeutic effects of curcumin against COVID-19.

scholarly journals Cyclooxygenase Inhibition Safety and Efficacy in Inflammation-Based Psychiatric Disorders

Molecules ◽  
2020 ◽  
Vol 25 (22) ◽  
pp. 5388
Author(s):  
Maria Grazia Perrone ◽  
Antonella Centonze ◽  
Morena Miciaccia ◽  
Savina Ferorelli ◽  
Antonio Scilimati
Keyword(s):  
Psychiatric Disorders ◽  
Potential Role ◽  
Autism Spectrum ◽  
World Health ◽  
Cox Inhibitors ◽  
First Choice ◽  
Inflammatory Drugs ◽  
Health Organization ◽  
Broad Overview

According to the World Health Organization, the major psychiatric and neurodevelopmental disorders include major depression, bipolar disorder, schizophrenia, and autism spectrum disorder. The potential role of inflammation in the onset and progression of these disorders is increasingly being studied. The use of non-steroidal anti-inflammatory drugs (NSAIDs), well-known cyclooxygenase (COX) inhibitors, combined with first-choice specific drugs have been long investigated. The adjunctive administration of COX inhibitors to classic clinical treatments seems to improve the prognosis of people who suffer from psychiatric disorders. In this review, a broad overview of the use of COX inhibitors in the treatment of inflammation-based psychiatric disorders is provided. For this purpose, a critical analysis of the use of COX inhibitors in the last ten years of clinical trials of the major psychiatric disorders was carried out.

scholarly journals The Contribution from Relationships with Parents and Teachers to the Adolescent Sense of Coherence

Young ◽  
2016 ◽  
Vol 25 (4) ◽  
pp. 391-406 ◽  
Author(s):  
Irene García-Moya ◽  
Antonia Jiménez-Iglesias ◽  
Carmen Moreno
Keyword(s):  
Sense Of Coherence ◽  
Potential Role ◽  
Well Being ◽  
Analysis Of Covariance ◽  
World Health ◽  
Positive Development ◽  
Individual Factors ◽  
School Aged Children ◽  
Health Organization

Sense of coherence (SOC) is receiving increasing attention from a number of disciplines interested in the study of adolescent positive development. Given the significant links between SOC and well-being, attention is now moving to the precursors of SOC. The aim of this study was to analyze the contribution of relationships with parents and teachers (contextual factors) to young people’s SOC while taking into account the potential role of individual differences in prosociality and hyperactivity-inattention (individual factors). The sample consisted of 2,979 adolescents aged 15–18 who had participated in the 2010 edition of the World Health Organization (WHO) survey ‘Health Behaviour in School-aged Children’ (HBSC) in Spain. Data were collected by means of anonymous online questionnaires, and statistical analyses included factorial analysis of variance (ANOVA) and analysis of covariance (ANCOVA). Both contextual and individual factors made significant contributions to the adolescents’ SOC. Importantly, the significance of relationships with parents and teachers remained once prosociality and hyperactivity-inattention were taken into account.

A Historical Perspective and Exposé on Serrated Polyps of the Colorectum

2016 ◽  
Vol 140 (10) ◽  
pp. 1079-1084 ◽  
Author(s):  
Eun-Young Karen Choi ◽  
Henry D. Appelman
Keyword(s):  
Historical Perspective ◽  
Hyperplastic Polyp ◽  
Colorectal Polyps ◽  
Hyperplastic Polyps ◽  
Sessile Serrated Adenoma ◽  
Serrated Adenoma ◽  
Serrated Polyps ◽  
The Third ◽  
The Past ◽  
Serrated Polyp

This article offers a historical perspective on the discovery of 3 types of serrated colorectal polyps recognized in the past 60 years. The first to be discovered was the hyperplastic polyp, which is still the most commonly encountered serrated polyp. In the past 20 years, the carcinoma-associated sessile serrated adenoma/polyp has been recognized, but its diagnosis can be difficult owing to overlapping histologic features with hyperplastic polyps. Less is known about the third type, the traditional serrated adenoma, because it is far less common than the other 2 types, and its association with cancer is currently under investigation.

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