Oesophageal Mycosis: Epidemiological and Clinical Aspects and Risk Factors for Occurrence in the Digestive Endoscopy Unit of the Donka National Hospital, Conakry CHU

Introduction: Oesophageal mycosis (OM) is one of the most common opportunistic infections in patients infected with HIV (Human Immunodeficiency Virus). However, this condition is increasingly observed in immunocompetent subjects. The aim of this study was to determine the endoscopic prevalence, clinical characteristics and risk factors for the occurrence of oesophageal mycosis in our department. Patients and Method: This was a prospective cross-sectional study of all patients who underwent oeso-gastroduodenal fibroscopy during the period from 1st January to 31st December 2022, i.e. one year, at the digestive endoscopy unit of the hepato-gastroenterology department of the Donka CHU national hospital in Conakry. All patients found to have oesophageal mycosis by FOGD were included. The endoscopy was performed using appropriate equipment: A Fujinon 4400 video endoscopy column;Three Fujinon EG 590 video gastroscopes;A hoover;Data were collected using a pre-established survey form and analysed using Epi info software version 6.0.4;Pearson’s Chi2 test as a test of independence and the exact 5% threshold ficher test. Results: Out of 1343 upper gastrointestinal endoscopies performed, 107 cases of oesophageal mycosis were found, representing a prevalence of 7.96%. The mean age was 40 years, with a male predominance of 55.42%. The sex ratio M/F was 1.24. The 45 and over age group was the most affected, with a prevalence of 40.43%, followed by the [35 - 45] age group, with a prevalence of 22.43%. Clinical symptoms were dominated by epigastralgia in 74.76% of cases, followed by odynophagia in 37.38% of cases, nausea and vomiting in 28.03% of cases, and pyrosis in 26.16% of cases. Oesophageal mycosis without oesophagitis was the most common endoscopic finding in 70% of cases. The main associated endoscopic lesions were erythemato-erosive and congestive gastropathy in 28.03% of cases, peptic oesophagitis (9.34%) and gastric ulcer (5.60%). The main risk factors found were positive HIV serology in 39.25% of cases, and diabetes in 24.30% of cases, with a statistically significant relationship of 0.02 and 0.01 respectively. Conclusion: Oesophageal mycosis is the most common opportunistic infection in patients with impaired cellular immunity. The prevalence of oesophageal mycosis in our series was 7.96%. This study enabled us to identify the main risk factors for the occurrence of oesophageal mycosis. Our country needs to step up its programme to combat and prevent immunodeficiency diseases, particularly HIV and diabetes.

Research trends on artificial intelligence and endoscopy in digestive diseases: A bibliometric analysis from 1990 to 2022

BACKGROUND Recently,artificial intelligence(AI)has been widely used in gastrointestinal endoscopy examinations.AIM To comprehensively evaluate the application of AI-assisted endoscopy in detecting different digestive diseases using bibliometric analysis.METHODS Relevant publications from the Web of Science published from 1990 to 2022 were extracted using a combination of the search terms“AI”and“endoscopy”.The following information was recorded from the included publications:Title,author,institution,country,endoscopy type,disease type,performance of AI,publication,citation,journal and H-index.RESULTS A total of 446 studies were included.The number of articles reached its peak in 2021,and the annual citation numbers increased after 2006.China,the United States and Japan were dominant countries in this field,accounting for 28.7%,16.8%,and 15.7%of publications,respectively.The Tada Tomohiro Institute of Gastroenterology and Proctology was the most influential institution.“Cancer”and“polyps”were the hotspots in this field.Colorectal polyps were the most concerning and researched disease,followed by gastric cancer and gastrointestinal bleeding.Conventional endoscopy was the most common type of examination.The accuracy of AI in detecting Barrett’s esophagus,colorectal polyps and gastric cancer from 2018 to 2022 is 87.6%,93.7%and 88.3%,respectively.The detection rates of adenoma and gastrointestinal bleeding from 2018 to 2022 are 31.3%and 96.2%,respectively.CONCLUSION AI could improve the detection rate of digestive tract diseases and a convolutional neural network-based diagnosis program for endoscopic images shows promising results.

Hemostatic effect of topical hemocoagulase spray in digestive endoscopy

AIM: To evaluate the hemostatic effect of topical hemocoagulase spray in digestive endoscopy.METHODS: Eighty-nine patients who developed oozing bleeding during endoscopic treatment from September 2014 to October 2014 at Center for Digestive Endoscopy, Tianjin Medical University General Hospital were randomly divided into either a study group(n = 39) or a control group(n = 50). The study group was given topical hemocoagulase spray intraoperatively, while the control group was given traditional 8% norepinephrine spray. Hemostatic efficacy was compared between the two groups. Bleeding site, wound cleanliness and perforation were recorded, and the rates of perforation and late bleeding were compared.RESULTS: Successful hemostasis was achieved in 39(100%) patients of the study group and in 47(94.0%) patients of the control group, and there was no significant difference in the rate of successful hemostasis between the two groups. Compared with the control group, after topical hemocoagulase spray in the study group, the surgical field was clearer, the bleeding site was more easily identified, and the wound was cleaner. There was no significant difference in the rate of perforation between the study and control groups(16.7% vs 35.0%, P = 0.477), but the rates oflate bleeding(0% vs 15.8%, P = 0.048) and overall complications(P = 0.032) were significantly lower in the study group.CONCLUSION: Topical hemocoagulase spray has a definite hemostatic effect for oozing bleeding in digestive endoscopy, and this method is convenient, safe, and reliable. It is expected to become a new method for endoscopic hemostasis.

Carbon dioxide for gut distension during digestive endoscopy:Technique and practice survey

AIM:To assess the adoption of Carbon dioxide(CO2)insufflation by endoscopists from various European countries,and its determinants.METHODS:A survey was distributed to 580 endoscopists attending a live course on digestive endoscopy.RESULTS:The response rate was 24.5%.Fewer than half the respondents(66/142,46.5%)were aware of the fact that room air can be replaced by CO2 for gut distension during endoscopy,and 4.2%of respondents were actually using CO2 as the insufflation agent.Endoscopists aware of the possibility of CO2 insufflation mentioned technical difficulties in implementing the system and the absence of significant advantages of CO2 in comparison with room air as barriers to adoption in daily practice(84%and 49%of answers,respectively;two answers were permitted for this item).CONCLUSION:Based on this survey,adoption of CO2 insufflation during endoscopy seems to remain relatively exceptional.A majority of endoscopists were not aware of this possibility,while others were not aware of recent technical developments that facilitate CO2 implementation in an endoscopy suite.

Prevention program for the COVID-19 in a children’s digestive endoscopy center

The pneumonia caused by the coronavirus disease-2019(COVID-19)outbreak in Wuhan,China constitutes a public health emergency of international concern.The gastrointestinal symptoms of vomiting,diarrhea and abdominal pain and the detection of COVID-19 nucleic acid from fecal specimens in a small number of patients suggest the possibility of transmission via the gastrointestinal tract.People of all ages are vulnerable to this virus,including children.Digestive endoscopy is an invasive procedure during which children cannot wear masks;therefore,they have higher risks of exposure to COVID-19,and the digestive endoscopy center is a relatively high-risk area for COVID-19 infection.Based on these factors and in combination with related policies and regulations,a prevention and control program for the COVID-19 pneumonia in a children's digestive endoscopy center was established to prevent the COVID-19 nosocomial infection.

Gastritis: Sociodemographic, Clinical, Endoscopic and Histological Aspects, about 593 Cases at the Digestive Endoscopy Unit of the General Hospital Idrissa Pouye

Introduction: Gastritis is a very common and widely distributed condition worldwide. It represents one of the most common pathological entities in gastroenterology and digestive endoscopy. Our objective was to determine the sociodemographic, clinical, endoscopic, and histological aspects of gastritis in the digestive endoscopy unit of the General Hospital Idrissa Pouye (GHIP). Materials and Method: This was a retrospective study over a period of 4 years (from 1 January 2014 to 31 December 2017) at the digestive endoscopy unit of GHIP. We had collated oesogastroduodenal endoscopy (EGDE) reports with gastritis appearance with gastric biopsies and reports with normal stomach appearance with gastric biopsies and their histological reports. We collected and analyzed data on age, gender, indications for endoscopy, endoscopic findings and histological results. Results: The reports of 593 patients were analyzed. The mean age was 45 years old (range 8 - 88 years old) and the sex ratio was 0.63 (230 men). The indications for endoscopy were epigastralgia in (91%) of cases, dyspepsia in (22%) of cases, pyrosis in (12%) of cases. The endoscopic appearance was normal in 229 patients (39%). The endoscopic location of the gastritis was antral in 76%, fundic in 22% and pangastric in 2%. The gastritis was erythematous in 327 patients (90%), erosive in 126 patients (35%), congestive in 53 patients (15%), pseudonodular in 14 patients (4%) and atrophic in 10 patients (3%). Histology was normal in 8 patients (1.3%) and showed gastritis in 585 patients (98.7%). Gastritis was chronic in 575 patients (98.2%), acute in 10 patients (1.7%). Gastritis activity was moderate in (52.7%) and mild in (42.9%). Atrophy was absent in 521 patients (88.6%) and mild in 46 patients (8.2%). Intestinal metaplasia was found in 66 patients (11%). Dysplasia was present in 1.7% of cases. This dysplasia was intermediate grade (60%) in 6 patients, low grade (20%) in 2 patients and severe grade (20%). H. pylori was present in 404 patients (68%). Conclusion: Gastritis is usually found in the digestive endoscopy unit of the GHIP. The indications for endoscopy are dominated by epigastralgia and histology is necessary for its diagnosis.

Capsule endoscopy and panendoscopy:A journey to the future of gastrointestinal endoscopy

In 2000,the small bowel capsule revolutionized the management of patients with small bowel disorders.Currently,the technological development achieved by the new models of double-headed endoscopic capsules,as miniaturized devices to evaluate the small bowel and colon[pan-intestinal capsule endoscopy(PCE)],makes this non-invasive procedure a disruptive concept for the management of patients with digestive disorders.This technology is expected to identify which patients will require conventional invasive endoscopic procedures(colonoscopy or balloon-assisted enteroscopy),based on the lesions detected by the capsule,i.e.,those with an indication for biopsies or endoscopic treatment.The use of PCE in patients with inflammatory bowel diseases,namely Crohn’s disease,as well as in patients with iron deficiency anaemia and/or overt gastrointestinal(GI)bleeding,after a non-diagnostic upper endoscopy(esophagogastroduodenoscopy),enables an effective,safe and comfortable way to identify patients with relevant lesions,who should undergo subsequent invasive endoscopic procedures.The recent development of magnetically controlled capsule endoscopy to evaluate the upper GI tract,is a further step towards the possibility of an entirely non-invasive assessment of all the segments of the digestive tract,from mouth-to-anus,meeting the expectations of the early developers of capsule endoscopy.

Patients’ Lived Experience and Injuries Observed during Upper Digestive Endoscopy at KARA Teaching Hospital (Togo)

Background: Endoscopy remains the most performant medical exam exploring the upper digestive tract;but depending on patients, its tolerance is variable. Objective: This study aimed at describing the experience and evaluating the tolerance, acceptability and injuries observed during upper gastrointestinal endoscopy. Methods: This is a prospective and descriptive study carried out from April to July 2017 in the digestive endoscopy unit of the Kara teaching hospital (Togo). The gastroscopy was performed by the same operator (Hepatogastroenteroloogist). The premedication was done with direct intravenous injection of 10 mg of Metoclopramide hydrochloride and viscous Lidocaine oral gel. Previously, essential information about the examination course was given to patients after obtaining their verbal consent. Patients’ impressions of the experience, tolerance and acceptability were collected on a survey sheet, before and after the examination. Results: One hundred and eleven patients were included, 62 women and 49 men. The average age was 45.9 years (15 - 88 years), and the sex ratio (F/M) was 1.2. Most of the patients (89.2%) were experiencing the gastroscopy for the first time, and the main reason was epigastralgia in 55%. The examination duration was good at 88.3% and tolerance was good at 72.1%. Tingling, irritation, pain or sore throat feelings were noted in 13.5%. Patients agreeing to make an ulterior UDE if necessary were up to 92.8%. Observed injuries were dominated by antral erythematous gastropathy (28.8%). Conclusion: UDE is well tolerated among our patients and its acceptability is high. Injuries are dominated by inflammatory pathologies of the stomach in our population.

Foreign Bodies from the Upper Digestive Tract at University Hospital Center Gabriel Touré: The Contribution of Digestive Endoscopy

Foreign bodies ingestion is regularly observed in gastroenterology context. The evolution is favorable with early extraction. Our main objective was to evaluate foreign bodies managed in digestive endoscopic center of University hospital center Gabriel Touré. The study was retrospective from January 2007 to October 2017 in the endoscopic center of the service of gastroenterology of University hospital center Gabriel Touré and concerned the patients who have been addressed at this center for foreign bodies. We collated 44 patients who ingested foreign bodies among 2750 digestive endoscopies, that is to say, a frequency of 0.16%. In patient’s history, we found caustic obstruction in 2.3% of patients. The foreign body ingestion was accidental in 97.7% of cases. Pieces of money were more frequent (54.4%). In 86.4%, the foreign bodies were into the esophagus. Upper digestive endoscopy performed foreign bodies extraction in 88.6 of cases. In 9.1%, the elimination was spontaneous on 72 hours. Surgeon was indicated in 2.3% of patients. The evolution was favorable in 97.7% of patients. One patient died by digestive bleeding. Conclusion: Foreign bodies ingestion is frequent in children. The upper digestive endoscopy can do the diagnosis and the management.

Profile of Endoscopic Lesions and Prevalence of <i>H. pylori</i>Infection at the Digestive Endoscopy Unit of Panzi General Reference Hospital in Bukavu

Introduction: Thanks to the opening of the digestive endoscopy unit in the Reference General Hospital of Panzi in Bukavu in the Democratic Republic of the Congo, which inspired our work on the profile of endoscopic lesions observed in a series of 1000 patients correlated with clinical and demographic criteria with the contribution of pathology examinations of the 292 biopsies performed. The aim of our work is to evaluate the prevalence of significant endoscopic lesions as well as that of H. pylori infection. Material and Methods: This is a retrospective, descriptive and analytical study, ranging from the 16th of December 2014 to the 16th of June 2016. It covered 1000 patients who benefited from a high digestive endoscopy and 292 of them had a biopsy with pathological examination. The data obtained were recorded and analyzed using the Epi-info software and chi-square test. Results: fifty-five percent of these patients were women. 66% of the patients were under 50 years of age. Their major symptom was epigastric pain (89.2%), the most observed endoscopic lesion was erythematous gastritis (82%) therefore we have noticed 21.5% of significant lesions. Gastric cancer was present in 3.9% of cases and gastric ulcer in 4.2% of cases. The gastric tumor was correlated with age and sex (P-value at 0.000 and 0.013). The gastroduodenal ulcer was linked to age, NSAID and tobacco use (P-value at 0.0007, 0.001, 0.007). Esophageal mycosis was correlated with HIV status (P-value at 0.000). Helicobacter pylori gastritis was the most frequent (61.30%) and Helicobacter pylori were present in 63% of gastric biopsies. Conclusion: Upper digestive endoscopy is a major tool for the diagnosis of upper gastrointestinal disorders and should always be followed by a biopsy if there is a suspicious lesion for pathologic confirmation and adequate management.

Endoscopy in screening for digestive cancer

The aim of this study is to describe the role of endoscopy in detection and treatment of neoplastic lesions of the digestive mucosa in asymptomatic persons.Esophageal squamous cell cancer occurs in relation to nutritional deficiency and alcohol or tobacco consumption.Esophageal adenocarcinoma develops in Barrett's esophagus,and stomach cancer in chronic gastric atrophy with Helicobacter pylori infection.Colorectal cancer is favoured by a high intake in calories,excess weight,low physical activity.In opportunistic or individual screening endoscopy is the primary detection procedure offered to an asymptomatic individual.In organized or mass screening proposed by National Health Authorities to a population,endoscopy is performed only in persons found positive to a filter selection test.The indications of primary upper gastrointestinal endoscopy and colonoscopy in opportunistic screening are increasingly developing over the world.Organized screening trials are proposed in some regions of China at high risk for esophageal cancer;the selection test is cytology of a balloon or sponge scrapping;they are proposed in Japan for stomach cancer with photofluorography as a selection test;and in Europe,America and Japan;for colorectal cancer with the fecal occult blood test as a selection test.Organized screening trials in a country require an evaluation:the benefit of the intervention assessed by its impact on incidence and on the 5 year survival for the concerned tumor site;in addition a number of bias interfering with the evaluation have to be controlled.Drawbacks of screening are in the morbidity of the diagnostic and treatment procedures and in overdetection of none clinically relevant lesions.The strategy of endoscopic screening applies to early cancer and to benign adenomatous precursors of adenocarcinoma.Diagnostic endoscopy is conducted in 2 steps:at first detection of an abnormal area through changes in relief,in color or in the course of superficial capillaries;then characterization of the morphology of the lesion according to the Paris classification and prediction of the risk of malignancy and depth of invasion,with the help of chromoscopy,magnification and image processing with neutrophil bactericidal index or FICE.Then treatment decision offers 3 options according to histologic prediction:abstention,endoscopic resection,surgery.The rigorous quality control of endoscopy will reduce the miss rate of lesions and the occurrence of interval cancer.

High technology imaging in digestive endoscopy

A thorough endoscopic visualization of the digestive mucosa is essential for reaching an accurate diagnosis and to treat the different lesions. Standard white light endoscopes permit a good mucosa examination but, nowadays, the introduction of powerful endoscopic instrumentations increased ability to analyze the fi nest details. By applying dyes and zoom-magnifi cation endoscopy further architectural detail of the mucosa can be elucidated. New computed virtual chromoendoscopy have further enhanced optical capabilities for the evaluation of submucosal vascolar pattern. Recently, confocal endomicroscopy and endocytoscopy were proposed for the study of ultrastructural mucosa details. Because of the technological contents of powerful instrumentation, a good knowledge of implemented technologies is mandatory for the endoscopist, nowadays. Nevertheless, there is a big confusion about this topic. We will try to explain these technologies and to clarify this terminology.

Upper Gastrointestinal Endoscopy and Children Digestive Pathology in Abidjan

The aim of our study is to determine the demographic data, indications, performance, and security of gastroscopy in children in Ivory Coast. Patients and Methods: This is a retrospective analytical study based on reports of upper digestive endoscopy per-formed in children (from 1 day to 15 years included) in 2 university hospitals in Abid-jan from March 2009 to March 2016. Results: 276 upper gastrointestinal endoscopies (UGIE) were performed in children during the study period. UGIE was performed with a diagnostic purpose in most cases (99%). The indications of UGIE were abdominal pains (38.95%), ingestion of caustic substances (29.82%), upper gastrointestinal bleeding (10.87%) and vomiting (10.17%). UGIE was normal in 39.49% of cases for all ages. The main anomalies observed in upper gastrointestinal (GI) endoscopy for all ages were gastropathies (29%);caustic lesions (13.02%) and bile reflux (10.45%). Ul-cers were rarely found (2.54%). Histological examination of biopsies revealed chronic H. pylori gastritis in 67% of gastric samples examined. All endoscopic examinations were performed without incident. Conclusion: Gastroscopy is a harmless examination with a great diagnostic and therapeutic utility in digestive pathology of children in Ivory Coast.

Therapeutic Profile and Prognostic Factors of Patients Suffering from Upper Digestive Bleeding at Sikasso Regional Hospital

Introduction: Upper digestive hemorrhage is one of the main digestive emergencies and remains a major cause of morbidity and mortality in Mali. The aim of this study was to describe the therapeutic profile and outcome of patients suffering from upper digestive haemorrhage. Methodology: This was a prospective study carried out in the internal medicine department of the Sikasso Regional Hospital from August 2022 to July 2023. All adult patients presenting with upper digestive haemorrhage and having given their consent, were included. Data were analyzed using SPSS version 21 software. Results: Sixty-three patients were enrolled. The mean age was 49.7 ± 18.99 years, with a male-female sex ratio of 2.2. Ruptured esophageal varices (37.5%) and peptic ulcer (25%) were the main etiologies. Pharmacological treatment was dominated by proton pump inhibitors (85.7%). Hemostasis endoscopy accounted for 3.17%. The evolution was marked by hemorrhagic arrest (69.84%), recurrence of hemorrhage (11.11%) and death (19.04%), the main cause of which was hemorrhagic shock (58.3%). We found no statistically significant relationship between prognosis and etiologies (P = 0.11), and length of hospital stay (P = 0.18). Conclusion: Hemostasis endoscopy remains a challenge for Sikasso Hospital. A holistic strategy of communication and community awareness-raising, combined with adequate technical facilities, will help to improve patient care and outcomes.

Informed consent for digestive endoscopy

Informed consent is necessary in good clinical practice.It is based on the patient’s ability to understand the information about the proposed procedure,the potential consequences and complications,and alternative options.The information is written in understandable language and is fortified by verbal discussion between physician and patient.The aim is to explain the problem,answer all questions and to ensure that the patient understands the problems and is able to make a decision.The theory is clear but what happens in daily practice?

Clinical and demographic features of patients undergoing videocapsule endoscopy management:A descriptive study

BACKGROUND Video-capsule endoscopy(VCE)is an efficient tool that has proven to be highly useful in approaching several gastrointestinal diseases.VCE was implemented in Colombia in 2003,however current characterization of patients undergoing VCE in Colombia is limited,and mainly comes from two investigations conducted before the SARS-CoV-2 pandemic period.AIM To describe the characteristics of patients undergoing VCEs and establish the main indications,findings,technical limitations,and other outstanding features.METHODS A descriptive study was carried out using data from reports of VCE(PillCam SB3 system)use in a Gastroenterology Unit in Bogotá,Colombia between September 2019 and January 2023.Demographic and clinical variables such as indication for the VCE,gastric and small bowel transit times(GTT,SBTT),endoscopic preparation quality,and limitations were described[n(%),median(IQR)].RESULTS A total of 133 VCE reports were analyzed.Most were in men with a median age of 70 years.The majority had good preparation(96.2%),and there were technical limitations in 15.8%of cases.The main indications were unexplained anemia(91%)or occult bleeding(23.3%).The median GTT and SBTT were 14 and 30 minutes,respectively.The frequencies of bleeding stigma(3.79%)and active bleeding(9.09%)were low,and the most frequent abnormal findings were red spots(28.3%),erosions(17.6%),and vascular ectasias(12.5%).CONCLUSION VCE showed high-level safety.The main indication was unexplained anemia.Active bleeding was the most frequent finding.Combined with artificial intelligence,VCE can improve diagnostic precision and targeted therapeutic interventions.

Standard-definition White-light,High-definition White-light versus Narrow-band Imaging Endoscopy for Detecting Colorectal Adenomas:A Multicenter Randomized Controlled Trial

Objective This study aimed to compare the performance of standard-definition white-light endoscopy(SD-WL),high-definition white-light endoscopy(HD-WL),and high-definition narrow-band imaging(HD-NBI)in detecting colorectal lesions in the Chinese population.Methods This was a multicenter,single-blind,randomized,controlled trial with a non-inferiority design.Patients undergoing endoscopy for physical examination,screening,and surveillance were enrolled from July 2017 to December 2020.The primary outcome measure was the adenoma detection rate(ADR),defined as the proportion of patients with at least one adenoma detected.The associated factors for detecting adenomas were assessed using univariate and multivariate logistic regression.Results Out of 653 eligible patients enrolled,data from 596 patients were analyzed.The ADRs were 34.5%in the SD-WL group,33.5%in the HD-WL group,and 37.5%in the HD-NBI group(P=0.72).The advanced neoplasm detection rates(ANDRs)in the three arms were 17.1%,15.5%,and 10.4%(P=0.17).No significant differences were found between the SD group and HD group regarding ADR or ANDR(ADR:34.5%vs.35.6%,P=0.79;ANDR:17.1%vs.13.0%,P=0.16,respectively).Similar results were observed between the HD-WL group and HD-NBI group(ADR:33.5%vs.37.7%,P=0.45;ANDR:15.5%vs.10.4%,P=0.18,respectively).In the univariate and multivariate logistic regression analyses,neither HD-WL nor HD-NBI led to a significant difference in overall adenoma detection compared to SD-WL(HD-WL:OR 0.91,P=0.69;HD-NBI:OR 1.15,P=0.80).Conclusion HD-NBI and HD-WL are comparable to SD-WL for overall adenoma detection among Chinese outpatients.It can be concluded that HD-NBI or HD-WL is not superior to SD-WL,but more effective instruction may be needed to guide the selection of different endoscopic methods in the future.Our study’s conclusions may aid in the efficient allocation and utilization of limited colonoscopy resources,especially advanced imaging technologies.

A Comprehensive Study of the Association between LEPR Gene rs1137101 Variant and Risk of Digestive System Cancers

Objective The leptin receptor,encoded by the LEPR gene,is involved in tumorigenesis.A potential functional variant of LEPR,rs1137101(Gln223Arg),has been extensively investigated for its contribution to the risk of digestive system(DS)cancers,but results remain conflicting rather than conclusive.Here,we performed a case–control study and subsequent meta-analysis to examine the association between rs1137101 and DS cancer risk.Methods A total of 1,727 patients with cancer(gastric/liver/colorectal:460/480/787)and 800 healthy controls were recruited.Genotyping of rs1137101 was conducted using a polymerase chain reactionrestriction fragment length polymorphism(PCR-RFLP)assay and confirmed using Sanger sequencing.Twenty-four eligible studies were included in the meta-analysis.Results After Bonferroni correction,the case–control study revealed that rs1137101 was significantly associated with the risk of liver cancer in the Hubei Chinese population.The meta-analysis suggested that rs1137101 is significantly associated with the risk of overall DS,gastric,and liver cancer in the Chinese population.Conclusion The LEPR rs1137101 variant may be a genetic biomarker for susceptibility to DS cancers(especially liver and gastric cancer)in the Chinese population.

Insights into the history and tendency of glycosylation and digestive system tumor:A bibliometric-based visual analysis

BACKGROUND Glycosylation,a commonly occurring post-translational modification,is highly expressed in several tumors,specifically in those of the digestive system,and plays a role in various cellular pathophysiological mechanisms.Although the importance and detection methods of glycosylation in digestive system tumors have garnered increasing attention in recent years,bibliometric analysis of this field remains scarce.The present study aims to identify the developmental trends and research hotspots of glycosylation in digestive system tumors.AIM To find and identify the developmental trends and research hotspots of glycosylation in digestive system tumors.METHODS We obtained relevant literature from the Web of Science Core Collection and employed VOSviewer 1.6.19 and CiteSpace(version 6.1.R6)to perform bibliometric analysis.RESULTS A total of 2042 documents spanning from 1978 to the present were analyzed,with the research process divided into three phases:the period of obscurity(1978-1990),continuous development period(1991-2006),and the rapid outbreak period(2007-2023).These documents were authored by researchers from 66 countries or regions,with the United States and China leading in terms of publication output.Reis Celso A had the highest number of publications,while Pinho SS was the most cited author.Co-occurrence analysis revealed the most popular keywords in this field are glycosylation,expression,cancer,colorectal cancer,and pancreatic cancer.Furthermore,the Journal of Proteome Research was the most prolific journal in terms of publications,while the Journal of Biological Chemistry had the most citations.CONCLUSION The bibliometric analysis shows current research focus is primarily on basic research in this field.However,future research should aim to utilize glycosylation as a target for treating tumor patients.

Digestive Surgical Emergencies at the “Mother Child”Hospital Center Luxembourg in Mali

Digestive surgical emergencies concern all patients admitted urgently, for whom a decision for surgical intervention may be necessary within 24 hours. They are on guard duty day and night. To carry out this work, we set ourselves the objectives of: 1) Studying digestive surgical emergencies in the general surgery department of the “Mother Child” Le Luxembourg hospital in Bamako, Mali;2) Determine the frequency of digestive surgical emergencies, 3) Describe the clinical and therapeutic aspects, and 4) Analyze the results of treatment. From November 1, 2022 to October 31, 2023, the general surgery department of the “Mother Child” Luxembourg Hospital Center in Bamako, Mali, carried out 139 digestive surgical emergencies whose files were usable;75 men and 64 women, a sex ratio of 1.2. The 20 - 40 years old age group was the most represented, at 40.29%. The average age was 39 years;the extremes 16 years and 93 years with a standard deviation of 21.65 years. The reference concerned 51.08% of our patients. Abdominal pain was the main reason for consultation (100% of cases). In the majority of cases, the physical examination made it possible to make the diagnosis. Faced with certain clinical cases, we requested ultrasound (109/139), ASP (46/139) and CT (15/139). The main etiology was acute appendicitis with 42.45% of cases. The frequency of digestive surgical emergencies was 10.71% of all activities in the general surgery department of the “Mère Enfant” Le Luxembourg hospital center in Bamako. All our patients were seen in consultation by an anesthesiologist before entering the operating room. The surgical consequences were complicated in 11.51% of cases with 7.91% deaths. Surgical site infections accounted for 12.5% of postoperative complications. Eleven deaths were noted, representing 68.75% of complications and 7.91% of our sample. Acute peritonitis was the cause of death in 100% of cases. The average cost of care was 329,000 FCFA.