Dietary flavonoids, lignans and colorectal cancer prognosis

Flavonoids and lignans are polyphenol classes with anticarcinogenic activities against colorectal cancer (CRC). However, very limited epidemiological evidence exists on their effects on CRC prognosis. This study aimed to evaluate the association between flavonoid and lignan intakes with the risk of CRC recurrence and overall survival in CRC patients. The study followed incident histologically confirmed CRC cases in Barcelona (Spain). Validated dietary questionnaires and lifestyle information were collected at recruitment. An ad hoc food composition database on flavonoids and lignans was compiled by using data from the US Department of Agriculture and Phenol-Explorer databases. Adjusted hazards ratios (HR) and 95% confidence intervals (CIs) were estimated using multivariable Cox models. After 8.6 years of mean follow-up, 133 of 409 (32.5%) participants died and 77 of 319 (24.1%) had a CRC recurrence. Total flavonoids were associated neither with CRC recurrence (HR comparing extreme tertiles 1.13, 95% CI 0.64-2.02; P-trend 0.67) nor with overall survival (HR(T3vsT1) 1.06, 95% CI 0.69-1.65; P-trend 0.78) in the multivariable models. No associations were also observed with either total lignans or any flavonoid subclass intake. In conclusion, the results of the current study do not support a role of flavonoid and lignan intake in the CRC prognosis

Omeprazole compared with misoprostol for ulcers associated with nonsteroidal antiinflammatory drugs

Background: Misoprostol is effective for ulcers associated with the use of nonsteroidal antiinflammatory drugs (NSAIDs) but is often poorly tolerated because of diarrhea and abdominal pain. We compared the efficacy of omeprazole and misoprostol in healing and preventing ulcers associated with NSAIDs. Methods: in a double-blind study, we randomly assigned 935 patients who required continuous NSAID therapy and who had ulcers or more than 10 erosions in the stomach or duodenum (or both) to receive 20 mg or 40 mg of omeprazole orally in the morning or 200 microg of misoprostol orally four times daily. Patients were treated for four weeks or, in the absence of healing, eight weeks. Treatment success was defined as the absence of ulcers and the presence of fewer than five erosions at each site and not more than mild dyspepsia. We then randomly reassigned 732 patients in whom treatment was successful to maintenance therapy with 20 mg of omeprazole daily, 200 microg of misoprostol twice daily, or placebo for six months. Results: at eight weeks, treatment was successful in 76 percent of the patients given 20 mg of omeprazole (233 of 308), 75 percent of those given 40 mg of omeprazole (237 of 315), and 71 percent of those given misoprostol (212 of 298). The rates of gastric-ulcer healing were significantly higher with 20 mg of omeprazole (but not 40 mg of omeprazole) than with misoprostol. Healing rates among patients with duodenal ulcers were higher with either dose of omeprazole than with misoprostol, whereas healing rates among patients with erosions alone were higher with misoprostol. More patients remained in remission during maintenance treatment with omeprazole (61 percent) than with misoprostol (48 percent, P=0.001) and with either drug than with placebo (27 percent, P<0.001). There were more adverse events during the healing phase in the misoprostol group than in the groups given 20 mg and 40 mg of omeprazole (59 percent, 48 percent, and 46 percent, respectively). Conclusions: the overall rates of successful treatment of ulcers, erosions, and symptoms associated with NSAIDs were similar for the two doses of omeprazole and misoprostol. Maintenance therapy with omeprazole was associated with a lower rate of relapse than misoprostol. Omeprazole was better tolerated than misoprostol

Comprehensive analysis of copy number aberrations in microsatellite stable colon cancer in view of stromal component

Background: Somatic copy number aberrations (CNA) are common acquired changes in cancer cells playing an important role in the progression of colon cancer (CRC). This study aimed to perform a characterization of CNA and their impact in gene expression.Methods: CNA were inferred from SNP array data in a series of 99 CRC. CNA events were calculated and used to assess the association between copy number dosage, clinical and molecular characteristics of the tumours, and gene expression changes. All analyses were adjusted for the quantity of stroma in each sample, that was inferred from gene expression data.Results: High heterogeneity among samples was observed, the proportion of altered genome ranged between 0.04 and 26.6%. Recurrent CNA regions with gains were frequent in chromosomes 7p, 8q, 13q, and 20 while 8p, 17p, and 18 cumulated loses. A significant positive correlation was observed between the number of somatic mutations and total CNA (Spearman r=0.42, P=0.006). Approximately 37% of genes located in CNA regions changed their level of expression, and the average partial correlation (adjusted for stromal content) with copy number was 0.54 (inter-quartile range 0.20 to 0.81). Altered genes showed enrichment in pathways relevant for colorectal cancer. Tumours classified as CMS2 and CMS4 by the consensus molecular subtyping showed higher frequency of CNA. Loses of one small region in 1p36.33, with gene CDK11B, were associated with poor prognosis. More than 66% of the recurrent CNA were validated in the TCGA data when analysed with the same procedure. Also 79% of the genes with altered expression in our data were validated in the TCGA.Conclusion: Though CNA are frequent events in MSS CRC, few focal recurrent regions were found. These aberrations have strong effects on gene expression and contribute to deregulate relevant cancer pathways. Due to the diploid nature of stromal cells, it is important to consider the purity of tumour samples to accurately calculate CNA events in CRC

European Registry on Helicobacter pylori Management: Effectiveness of First and Second-Line Treatment in Spain

The management of Helicobacter pylori infection has to rely on previous local effectiveness due to the geographical variability of antibiotic resistance. The aim of this study was to evaluate the effectiveness of first and second-line H. pylori treatment in Spain, where the empirical prescription is recommended. A multicentre prospective non-interventional registry of the clinical practice of European gastroenterologists concerning H. pylori infection (Hp-EuReg) was developed, including patients from 2013 until June 2019. Effectiveness was evaluated descriptively and through a multivariate analysis concerning age, gender, presence of ulcer, proton-pump inhibitor (PPI) dose, therapy duration and compliance. Overall, 53 Spanish hospitals were included, and 10,267 patients received a first-line therapy. The best results were obtained with the 10-day bismuth single-capsule therapy (95% cure rate by intention-to-treat) and with both the 14-day bismuth-clarithromycin quadruple (PPI-bismuth-clarithromycin-amoxicillin, 91%) and the 14-day non-bismuth quadruple concomitant (PPI-clarithromycin-amoxicillin-metronidazole, 92%) therapies. Second-line therapies were prescribed to 2448 patients, with most-effective therapies being the triple quinolone (PPI-amoxicillin-levofloxacin/moxifloxacin) and the bismuth-levofloxacin quadruple schemes (PPI-bismuth-levofloxacin-amoxicillin) prescribed for 14 days (92%, 89% and 90% effectiveness, respectively), and the bismuth single-capsule (10 days, 88.5%). Compliance, longer duration and higher acid inhibition were associated with higher effectiveness. "Optimized" H. pylori therapies achieve over 90% success in Spain

Ausencia de interferencia de almagato en los resultados de la prueba de aliento para el diagnóstico de Helicobacter pylori (estudio Almatest)

Objetivo: El test del aliento con 13C-urea (TAU) es la prueba no invasiva más utilizada para diagnosticar Helicobacter pylori (H. pylori). La posible interferencia de la toma de antiácidos en su resultado es aún controvertida. El estudio se dirige a confirmar la no interferencia del almagato en la determinación de H. pylori mediante el TAU. Pacientes y métodos: Estudio observacional, multicéntrico, en pacientes adultos en tratamiento con almagato y a los que se indicó un TAU (TAUKIT®). Cuando el resultado del TAU fue negativo, se suprimió la toma de almagato durante 30 días y se repitió un segundo TAU. En los pacientes cuyo resultado fue positivo, no se realizaron más determinaciones. La variable principal a estudio fue el porcentaje de pacientes que teniendo resultado negativo en la primera prueba de aliento, tras suprimir la toma de almagato y repetirla, ésta se positivizó (falsos negativos del TAU, posiblemente atribuibles a almagato). Resultados: De los 167 pacientes evaluables, 59% fueron mujeres, la media de edad fue de 49 a ̃nos y 97% de los casos presentaban sintomatología digestiva. El resultado del primer TAU fue negativo en un 71% de casos. De éstos, en la segunda prueba de TAU tras suprimir almagato, este resultado se confirmó en el 97,5%. El porcentaje de falsos negativos sobre el total de casos evaluados fue del 1,8%

lnfectious gastroenteritis in relapses of inflammatory disease. Therapeutic implications

No se conoce con exactitud la etiología ni la patogénesis de la enfermedad inflamatoria intestinal (EII), pero se sabe que es una enfermedad c rónica que cursa con exacerbaciones. Estas exacerbaciones pueden desencadenarse por noxas entre las que destacan los agentes infecciosos y los fármacos. Como agentes infecciosos se ha impl icado a los virus (citomegalovirus. virus respiratonos. enterovirus). bacterias (Clostridium difficile. enterobacterias. Mycoplasma pneumoniae y protozoos (Entamoeba histolytica. Blastocystis hominis) (1). Sin embargo. en la mayoría de brotes no se identifica desencadenante alguno. La infección bacteriana intestinal ha sido considerada por algunos au tores como factor desencadenante de brotes de EII. aunque esta posibilidad no es aceptada de forma unánime (1- 13). El objetivo de este estudio ha sido analizar prospectivamente la incidencia y trascendencia clínica de la gastroenteritis bacteriana en los brotes de EII

Dietary flavonoids, lignans and colorectal cancer prognosis

Flavonoids and lignans are polyphenol classes with anticarcinogenic activities against colorectal cancer (CRC). However, very limited epidemiological evidence exists on their effects on CRC prognosis. This study aimed to evaluate the association between flavonoid and lignan intakes with the risk of CRC recurrence and overall survival in CRC patients. The study followed incident histologically confirmed CRC cases in Barcelona (Spain). Validated dietary questionnaires and lifestyle information were collected at recruitment. An ad hoc food composition database on flavonoids and lignans was compiled by using data from the US Department of Agriculture and Phenol-Explorer databases. Adjusted hazards ratios (HR) and 95% confidence intervals (CIs) were estimated using multivariable Cox models. After 8.6 years of mean follow-up, 133 of 409 (32.5%) participants died and 77 of 319 (24.1%) had a CRC recurrence. Total flavonoids were associated neither with CRC recurrence (HR comparing extreme tertiles 1.13, 95% CI 0.64-2.02; P-trend 0.67) nor with overall survival (HR(T3vsT1) 1.06, 95% CI 0.69-1.65; P-trend 0.78) in the multivariable models. No associations were also observed with either total lignans or any flavonoid subclass intake. In conclusion, the results of the current study do not support a role of flavonoid and lignan intake in the CRC prognosis

Dietary flavonoids, lignans and colorectal cancer prognosis

Flavonoids and lignans are polyphenol classes with anticarcinogenic activities against colorectal cancer (CRC). However, very limited epidemiological evidence exists on their effects on CRC prognosis. This study aimed to evaluate the association between flavonoid and lignan intakes with the risk of CRC recurrence and overall survival in CRC patients. The study followed incident histologically confirmed CRC cases in Barcelona (Spain). Validated dietary questionnaires and lifestyle information were collected at recruitment. An ad hoc food composition database on flavonoids and lignans was compiled by using data from the US Department of Agriculture and Phenol-Explorer databases. Adjusted hazards ratios (HR) and 95% confidence intervals (CIs) were estimated using multivariable Cox models. After 8.6 years of mean follow-up, 133 of 409 (32.5%) participants died and 77 of 319 (24.1%) had a CRC recurrence. Total flavonoids were associated neither with CRC recurrence (HR comparing extreme tertiles 1.13, 95% CI 0.64-2.02; P-trend 0.67) nor with overall survival (HR(T3vsT1) 1.06, 95% CI 0.69-1.65; P-trend 0.78) in the multivariable models. No associations were also observed with either total lignans or any flavonoid subclass intake. In conclusion, the results of the current study do not support a role of flavonoid and lignan intake in the CRC prognosis

Comprehensive analysis of copy number aberrations in microsatellite stable colon cancer in view of stromal component

Background: Somatic copy number aberrations (CNA) are common acquired changes in cancer cells playing an important role in the progression of colon cancer (CRC). This study aimed to perform a characterization of CNA and their impact in gene expression.Methods: CNA were inferred from SNP array data in a series of 99 CRC. CNA events were calculated and used to assess the association between copy number dosage, clinical and molecular characteristics of the tumours, and gene expression changes. All analyses were adjusted for the quantity of stroma in each sample, that was inferred from gene expression data.Results: High heterogeneity among samples was observed, the proportion of altered genome ranged between 0.04 and 26.6%. Recurrent CNA regions with gains were frequent in chromosomes 7p, 8q, 13q, and 20 while 8p, 17p, and 18 cumulated loses. A significant positive correlation was observed between the number of somatic mutations and total CNA (Spearman r=0.42, P=0.006). Approximately 37% of genes located in CNA regions changed their level of expression, and the average partial correlation (adjusted for stromal content) with copy number was 0.54 (inter-quartile range 0.20 to 0.81). Altered genes showed enrichment in pathways relevant for colorectal cancer. Tumours classified as CMS2 and CMS4 by the consensus molecular subtyping showed higher frequency of CNA. Loses of one small region in 1p36.33, with gene CDK11B, were associated with poor prognosis. More than 66% of the recurrent CNA were validated in the TCGA data when analysed with the same procedure. Also 79% of the genes with altered expression in our data were validated in the TCGA.Conclusion: Though CNA are frequent events in MSS CRC, few focal recurrent regions were found. These aberrations have strong effects on gene expression and contribute to deregulate relevant cancer pathways. Due to the diploid nature of stromal cells, it is important to consider the purity of tumour samples to accurately calculate CNA events in CRC

Comprehensive analysis of copy number aberrations in microsatellite stable colon cancer in view of stromal component

Background: Somatic copy number aberrations (CNA) are common acquired changes in cancer cells playing an important role in the progression of colon cancer (CRC). This study aimed to perform a characterization of CNA and their impact in gene expression.Methods: CNA were inferred from SNP array data in a series of 99 CRC. CNA events were calculated and used to assess the association between copy number dosage, clinical and molecular characteristics of the tumours, and gene expression changes. All analyses were adjusted for the quantity of stroma in each sample, that was inferred from gene expression data.Results: High heterogeneity among samples was observed, the proportion of altered genome ranged between 0.04 and 26.6%. Recurrent CNA regions with gains were frequent in chromosomes 7p, 8q, 13q, and 20 while 8p, 17p, and 18 cumulated loses. A significant positive correlation was observed between the number of somatic mutations and total CNA (Spearman r=0.42, P=0.006). Approximately 37% of genes located in CNA regions changed their level of expression, and the average partial correlation (adjusted for stromal content) with copy number was 0.54 (inter-quartile range 0.20 to 0.81). Altered genes showed enrichment in pathways relevant for colorectal cancer. Tumours classified as CMS2 and CMS4 by the consensus molecular subtyping showed higher frequency of CNA. Loses of one small region in 1p36.33, with gene CDK11B, were associated with poor prognosis. More than 66% of the recurrent CNA were validated in the TCGA data when analysed with the same procedure. Also 79% of the genes with altered expression in our data were validated in the TCGA.Conclusion: Though CNA are frequent events in MSS CRC, few focal recurrent regions were found. These aberrations have strong effects on gene expression and contribute to deregulate relevant cancer pathways. Due to the diploid nature of stromal cells, it is important to consider the purity of tumour samples to accurately calculate CNA events in CRC