Gastric cancer screening in common variable immunodeficiency

Individuals with common variable immunodeficiency (CVID) have an increased risk of gastric cancer, and gastrointestinal lymphoma, yet screening for premalignant gastric lesions is rarely offered routinely to these patients. Proposed screening protocols are not widely accepted and are based on gastric cancer risk factors that are not applicable to all CVID patients. Fifty-two CVID patients were recruited for screening gastroscopy irrespective of symptoms or blood results and were compared to 40 controls presenting for gastroscopy for other clinical indications. Overall, 34% of CVID patients had intestinal metaplasia (IM), atrophic gastritis or moderate to severe non-atrophic gastritis, which can increase the risk of gastric cancer, compared to 7.5% of controls (p < 0.01). Focal nodular lymphoid hyperplasia, a precursor lesion for gastrointestinal lymphoma, was seen in eight CVID patients (16%), one of whom was diagnosed with gastrointestinal lymphoma on the same endoscopy. High-risk gastric pathology was associated with increased time since diagnosis of CVID, smoking, Helicobacter pylori, a low-serum pepsinogen I concentration, and diarrhea, but not pepsinogen I/II ratio, iron studies, vitamin B12 levels or upper gastrointestinal symptoms. There was a lower rate of detection of IM when fewer biopsies were taken, and IM and gastric atrophy were rarely predicted by the endoscopist macroscopically, highlighting the need for standardized biopsy protocols. The prevalence of premalignant gastric lesions in patients with CVID highlights the need for routine gastric screening. We propose a novel gastric screening protocol to detect early premalignant lesions and reduce the risk of gastric cancer and gastric lymphoma in these patients

Spinning up a Daze: TESS Uncovers a Hot Jupiter orbiting the Rapid-Rotator TOI-778

NASA's Transiting Exoplanet Survey Satellite (TESS) mission, has been uncovering a growing number of exoplanets orbiting nearby, bright stars. Most exoplanets that have been discovered by TESS orbit narrow-line, slow-rotating stars, facilitating the confirmation and mass determination of these worlds. We present the discovery of a hot Jupiter orbiting a rapidly rotating (vsin(i)=35.1±1.0km/s) early F3V-dwarf, HD115447 (TOI-778). The transit signal taken from Sectors 10 and 37 of TESS's initial detection of the exoplanet is combined with follow-up ground-based photometry and velocity measurements taken from Minerva-Australis, TRES, CORALIE and CHIRON to confirm and characterise TOI-778b. A joint analysis of the light curves and the radial velocity measurements yield a mass, radius, and orbital period for TOI-778b of 2.76+0.24−0.23Mjup, 1.370±0.043Rjup and ∼4.63 days, respectively. The planet orbits a bright (V=9.1mag) F3-dwarf with M=1.40±0.05Msun, R=1.70±0.05Rsun, and logg=4.05±0.17. We observed a spectroscopic transit of TOI-778b, which allowed us to derive a sky-projected spin-orbit angle of 18∘±11∘, consistent with an aligned planetary system. This discovery demonstrates the capability of smaller aperture telescopes such as Minerva-Australis to detect the radial velocity signals produced by planets orbiting broad-line, rapidly rotating stars