Mucin pattern reflects the origin of the adenocarcinoma in Barrett's esophagus: a retrospective clinical and laboratorial study

<p>Abstract</p> <p>Background</p> <p>Mucin immunoexpression in adenocarcinoma arising in Barrett's esophagus (BE) may indicate the carcinogenesis pathway. The aim of this study was to evaluate resected specimens of adenocarcinoma in BE for the pattern of mucins and to correlate to the histologic classification.</p> <p>Methods</p> <p>Specimens were retrospectively collected from thirteen patients who underwent esophageal resection due to adenocarcinoma in BE. Sections were scored for the grade of intestinal metaplasia. The tissues were examined by immunohistochemistry for MUC2 and MUC5AC antibodies.</p> <p>Results</p> <p>Eleven patients were men. The mean age was 61 years old (varied from 40 to 75 years old). The tumor size had a mean of 4.7 ± 2.3 cm, and the extension of BE had a mean of 7.7 ± 1.5 cm. Specialized epithelium with intestinal metaplasia was present in all adjacent mucosas. Immunohistochemistry for MUC2 showed immunoreactivity in goblet cells, while MUC5AC was extensively expressed in the columnar gastric cells, localizing to the surface epithelium and extending to a variable degree into the glandular structures in BE. Tumors were classified according to the mucins in gastric type in 7/13 (MUC5AC positive) and intestinal type in 4/13 (MUC2 positive). Two tumors did not express MUC2 or MUC5AC proteins. The pattern of mucin predominantly expressed in the adjacent epithelium was associated to the mucin expression profile in the tumors, p = 0.047.</p> <p>Conclusion</p> <p>Barrett's esophagus adenocarcinoma shows either gastric or intestinal type pattern of mucin expression. The two types of tumors developed in Barrett's esophagus may reflect the original cell type involved in the malignant transformation.</p

Case report: Mechanical mitral prosthetic valve thrombosis in the context of COVID-19 despite effective anticoagulation.

The SARS-CoV2 virus has been an emerging virus since December 2019 and is the cause of a global pandemic whose clinical manifestations extend far beyond respiratory disease. A patient with severe coronavirus disease 2019 respiratory infection, carrying a mechanical mitral valve and under anticoagulation, was admitted to our cardiology department because of a new atrial fibrillation, which turned out to be related to thrombosis of the mitral mechanical valve. The pro-coagulant effect of the SARS-CoV2 virus does not spare patients at risk of thrombosis, even under effective anticoagulation. In patients with mechanical valves under vitamin K antagonist treatment, there is a high risk of thrombus formation. The treatment is based on thrombolysis by therapeutic anticoagulation, fibrinolysis, or surgery depending on the size, composition of thrombus, and clinical manifestation

Prise en charge coordonnée de l’hypertension artérielle entre le praticien et les spécialistes - Place de la dénervation rénale dans l’HTA résistante [Coordinated management of arterial hypertension]

Despite major therapeutic progress and the numerous poly-pill combinations available on the market today, the control of arterial hypertension remains widely insufficient. A multidisciplinary management putting together internal medicine, nephrology and cardiology specialist offers the best chances for patients to achieve their blood pressure goals, especially when suffering from resistant hypertension despite adequate prescription of the reference tri therapy: ACEI/ARA2 combined with a thiazide-like diuretic and calcium channel blocker. Recent studies and randomized trials from the last five years shed a new light on the value of renal denervation and its efficacy on lowering blood pressure. This will probably lead to the integration of this technique in the next guidelines and improve its adoption over the next years

Maladies du péricarde : quoi de neuf en 2016 ? [News about pericardial diseases in 2016]

The European Society of Cardiology published in 2015 the new Guidelines on the management of pericardial diseases. Based on experts' opinions and recent clinical studies of respectable size, the new guidelines thoroughly revisit the criteria for hospitalization and precisely define severe cases. Another highlight regards medication. From now, first-line medical therapy should include the association of colchicine to the traditional non steroidal anti-inflammatory drugs or aspirin. The bi-therapy is recommended as soon as the first episode of pericarditis, for duration of 3 months. The experts also recommend systematically performing a heart ultrasound for any form of pericardial disease and restricting physical activities especially if myocardial damage (perimyocarditis) is associated

Prise en charge cardio-oncologique : un nouveau défi pour le praticien [Cardio-oncological risk stratification and follow up: a new challenge for the general practitioner]

Rise of medical oncology, aging of populations and survival rates' improvement of patients suffering from cancer are all factors contributing to exponential rise of the exposure of patients to -cardiotoxic therapies. A multidisciplinary approach including a close cooperation between general practitioner and specialists will -promote an early identification and treatment of cardiovascular complications related to cancer treatments. This strategy has proven to have a truly positive impact on both cardiovascular and onco-logic prognosis. We will summarize throughout this article the last recommendations established by the European Society of Cardiology in terms of cardiovascular risk stratification and follow up planning through the use of clinical, biological and cardiac imaging data

Influence des canicules sur l’incidence du syndrome de Takotsubo : étude rétrospective en Valais [The influence of summer temperatures on the incidence of Takotsubo cardiomyopathy : a retrospective study]

Takotsubo cardiomyopathy (TK-CM) is a reversible acute left ventricular dysfunction that cannot be explained by an obstructive coronary lesion. The aim of our study was to explore the possible correlation between the incidence of TK-CM in summer and the average temperature, number of heat waves or number of days hotter than 30°C. 482 patients presented an acute coronary syndrome in the summers of 2012 until 2017 in our region. 15 patients met the inclusion and exclusion criteria and were diagnosed as TK-CM. The study analysis showed a statistically correlation between the number of heatwaves and the incidence of TK-CM (coefficient of correlation: 0.77; p = 0.04). This comforts the hypothesis of climatic influence on this pathology