Seidamir Pasha Tabaeian

Introduction and importance: Rectal schwannomas are exceptionally rare benign neurogenic tumors arising from Schwann cells of the enteric plexus. They account for a very small proportion of gastrointestinal schwannomas and often mimic malignant spindle-cell tumors such as gastrointestinal stromal tumors or leiomyosarcomas, posing a significant diagnostic challenge. Accurate differentiation is essential to avoid unnecessary radical surgery. Presentation of the case: We report a 38-year-old woman presenting with abdominal pain, constipation, hematochezia, and weight loss. Imaging and colonoscopy revealed a 4 × 5 cm rectal mass located 5 cm above the dentate line. Initial pathology suggested a malignant spindle cell tumor, but immunohistochemistry confirmed S100 and SOX10 positivity and CD117/DOG1 negativity, consistent with a rectal schwannoma. The patient underwent a laparoscopic total mesorectal excision with clear surgical margins. Postoperative recovery was uneventful, and no recurrence has been observed during follow-up. Clinical discussion: Due to their nonspecific presentation and radiologic overlap with other rectal neoplasms, rectal schwannomas are frequently misdiagnosed preoperatively. Histopathologic and immunohistochemical analysis remains the cornerstone of diagnosis. Surgical excision with negative margins is curative, while the role of adjuvant therapy is limited. Long-term follow-up is recommended due to uncertain patterns of recurrence. Conclusion: Rectal schwannomas are rare entities that can simulate malignant tumors both clinically and radiologically. Comprehensive diagnostic work-up and complete surgical resection are crucial for accurate diagnosis and favorable outcomes. Further studies are required to establish standardized management and follow-up protocols.

Colorectal cancer (CRC) is a common malignancy of the gastrointestinal tract and the second leading cause of cancer-related death. Hypertension (HTN) is the primary cause of death worldwide and a significant risk factor for malignancies, leading to the new concept of “Onco-Hypertension.” Angiotensin receptor blockers (ARB) are among the first-line drugs for the treatment of HTN, and in recent years, concerns have been raised about their potential carcinogenic substances. This research intended to determine the association of HTN and ARBs with the chance of developing a clinicopathological profile of CRC. This multicenter retrospective observational study comprised 800 controls without CRC and 650 patients with CRC from 2019 to 2023. Key demographic and clinicopathological data were collected. Using univariate and multivariate logistic regression models, adjusted and unadjusted odds ratios (OR) were computed to examine the impact of HTN and ARBs on the clinicopathological features and chance of developing colorectal cancer. HTN and the chance of developing CRC were initially shown to be positively significant (OR = 1.28, confidence interval = 1.02, 1.61). After adjusting for confounding variables, the OR was no longer statistically significant. An elevated chance of developing CRC was in patients with HTN who used ARB (OR = 2.65, confidence interval = 1.47, 4.79). Among the clinicopathological features of the tumor, stage ( P value < .001) and metastasis ( P value = .002) have a significant association with HTN. The findings of this study did not reveal a significant association between HTN and the chance of developing CRC. However, a positive association was observed between HTN and metastasis and stage. Results identify a possible signal of an increased chance of developing CRC linked to ARBs. However, further observational and analytical studies are necessary to elucidate the underlying mechanisms and confirm these findings.

Background Gastric cancer (GC) is one of the most prevalent cancers worldwide, with high mortality and economic burden. Early detection through cost-effective screening strategies can improve patient outcomes and optimize healthcare resource allocation. This systematic review evaluates the cost-effectiveness of various GC screening approaches. Methods A comprehensive search was conducted in Web of Science, Scopus, PubMed, Embase, the NHS Economic Evaluation Database, and Google Scholar for studies published between 1990 and 2023. Relevant studies were selected based on predefined inclusion and exclusion criteria. The CHEERS 2022 checklist was used to assess study quality. Results A total of 6027 studies were retrieved, and after a two-phase screening and quality assessment, 47 studies were included. Most studies originated from China, Japan, the USA, Singapore, and South Korea. Findings indicate that screening is generally more cost-effective than no screening. Endoscopy was more cost-effective than upper gastrointestinal (UGI) X-ray but not superior to Helicobacter pylori (H. pylori) screening, serum pepsinogen (PG) testing, or novel risk scoring methods. H. pylori screening was more cost-effective than endoscopy and symptomatic treatment but not superior to serum PG testing and risk scoring methods. Urea breath test (UBT)-based H. pylori screening was less cost-effective than most alternatives. Conclusions Selecting cost-effective GC screening strategies can improve early detection rates and reduce healthcare costs. Policymakers should consider population-specific factors when implementing screening programs to maximize health benefits and economic efficiency.

Background: Pyroptosis can play a significant role in the development of inflammatory bowel diseases such as ulcerative colitis (UC) and colorectal cancer (CRC). The expression pattern of two pyroptosis related-lncRNAs MIAT and Gm15441 was investigated in clinical samples of CRC with and without a history of UC. Methods: In this case-control study, 48 tumor samples from patients with CRC and 48 healthy adjacent tissue samples were studied. A quantitative PCR was completed to analyze the relative expression of lncRNAs GM15441 and MIAT. Quantitative expression levels of the lncRNAs in tumor and healthy tissues were compared. The potential relationship with clinicopathological features and diagnostic values of the lncRNAs were evaluated. Results: The expression levels of both lncRNAs MIAT and Gm15441 were significantly increased in CRC tissues in comparison with healthy tissues (P=0.038 and 0.012, respectively). Also, there was a significant relationship between the expression levels of lncRNA MIAT and lymph node metastasis, but not other clinicopathological characterizations. An AUC of 0.65 for lncRNA MIAT with a sensitivity of 62% and specificity of 54%, with a cut-off value of 2.9 (P= 0.025), and an AUC of 0.66 for lncRNA Gm15441, with a sensitivity of 68% and specificity of 52%, with a cut-off value 1.7 (P= 0.005) were detected. Conclusion: Dysregulated lncRNAs MIAT and Gm15441 in CRC can be more clinically important in cases of cancer related to UC due to their biological function in regulating the inflammation process, providing new ideas about the diagnosis and management of pyroptosis-related diseases.

Objective: Metabolic dysfunction-associated steatotic liver disease (MASLD), a worldwide public health challenge with a prevalence of around 25%, is strongly related to obesity and insulin resistance. The present study investigated the possible association between MASLD and the leptin gene (LEP) -2548G>A (rs7799039) polymorphism. Subjects and methods: A total of 250 subjects (125 biopsy-proven MASLD patients and 125 controls) were genotyped for the -2548G>A promoter variant using the PCR-RFLP technique. Results: There was no deviation from Hardy-Weinberg equilibrium for LEP [...] ABSTRACT Objective: Metabolic dysfunction-associated steatotic liver disease (MASLD), a worldwide public health challenge with a prevalence of around 25%, is strongly related to obesity and insulin resistance. The present study investigated the possible association between MASLD and the leptin gene (LEP) -2548G>A (rs7799039) polymorphism. Subjects and methods: A total of 250 subjects (125 biopsy-proven MASLD patients and 125 controls) were genotyped for the -2548G>A promoter variant using the PCR-RFLP technique. Results: There was no deviation from Hardy-Weinberg equilibrium for LEP

Objectives Our aim was to systematically review the cost-effectiveness of proton pump inhibitor (PPI) therapies and surgical interventions for gastro-oesophageal reflux disease (GORD). Design The study design was a systematic review of economic evaluations. Data sources We searched PubMed, Embase, Scopus, and Web of Science for publications from January 1990 to March 2023. Only articles published in English were eligible for inclusion. Eligibility criteria Studies were included if they were full economic evaluations comparing PPIs with surgical or alternative therapies for GORD. Excluded were narrative reviews, non-peer-reviewed articles, and studies not reporting cost-effectiveness outcomes. Data extraction and synthesis Two reviewers independently extracted data on study design, comparators, time horizon, and cost-effectiveness outcomes. The quality of studies was assessed using the Joanna Briggs Institute (JBI) checklist for economic evaluations. Results A total of 25 studies met the inclusion criteria. Laparoscopic Nissen fundoplication (LNF) was found to be cost-effective in long-term horizons, while PPIs were preferred for short- to medium-term outcomes. Differences in healthcare settings and methodological approaches influenced the study findings. Conclusions Strategic purchasing decisions for GORD treatment should consider the time horizon, healthcare setting, and cost structures. LNF may provide better long-term value, but PPIs remain effective for managing symptoms in the short term. Study registration PROSPERO, CRD42023474181.

One of the foremost causes of global healthcare burden is cancer of the gastrointestinal tract. The medical records, lab results, radiographs, endoscopic images, tissue samples, and medical histories of patients with gastrointestinal malignancies provide an enormous amount of medical data. There are encouraging signs that the advent of artificial intelligence could enhance the treatment of gastrointestinal issues with this data. Deep learning algorithms can swiftly and effectively analyze unstructured, high-dimensional data, including texts, images, and waveforms, while advanced machine learning approaches could reveal new insights into disease risk factors and phenotypes. In summary, artificial intelligence has the potential to revolutionize various features of gastrointestinal cancer care, such as early detection, diagnosis, therapy, and prognosis. This paper highlights some of the many potential applications of artificial intelligence in this domain. Additionally, we discuss the present state of the discipline and its potential future developments.

Background Colorectal cancer (CRC) is a very common cancer worldwide. CRC is characterized by some changes in the expression of oncogenic and tumor suppressor genes. These changes are associated with dysregulation of non-coding RNAs, including long non-coding RNAs (lncRNAs). LncRNAs are heterogeneous non-coding molecules without open reading frames. LncRNAs have been established as regulators in the development of CRC and clinical biomarkers for the CRC detection. In this project, we investigated the expression changes of two new lncRNAs named SFTA1P and MYOSLID in CRC patients. Materials and methods 30 samples of CRC tissue and 30 samples of normal tissue adjacent to the cancer tissue were obtained from patients. RNA extraction from tissue samples was performed using RNAX plus. ExcelRT™ Reverse Transcription Kit (SymBio, Korea) was used for cDNA synthesis. RealQ Plus 2x Master Mix Green Without ROX™ was used to perform a quantitative PCR (qPCR). REST, and SPSS software were used for statistical analysis. Result Our result demonstrated that lncRNAs MYOSLID and SFTA1P were significantly up-regulated in tumor tissues compared to healthy tissues with a fold change of 13.43 and 5.33 (P < 0.05) respectively. Based on the analysis of ROC curve, MYOSLID (AUC = 0.946, P < 0.0001, SE =0.0035) and SFTA1P (AUC = 0.800, P < 0.0001, SE = 0.059) were indicated as potential clinical hallmarks for CRC patients. Conclusion According to the results obtained from this research, lncRNAs SFTA1P and MYOSLID can be suggested as molecular biomarkers for the CRC diagnosis.

Aim: Nonalcoholic fatty liver disease (NAFLD) is a significant health issue worldwide. This study investigated the effect of the adiponectin receptor 1 gene (ADIPOR1) polymorphism on susceptibility to NAFLD.Methods: Data from 330 participants, including 165 biopsy-proven NAFLD patients and 165 healthy controls, were collected. The PCR-RFLP method was used to detect the genotypes of ADIPOR1 rs2275738 or T-106C variant.Results: The "CC" genotype of the ADIPOR1 rs2275738 polymorphism, compared with the "TT" genotype and the "C" allele, compared with the "T" allele, are markers of increased NAFLD susceptibility (p = 0.018; OR = 2.07, 95% CI = 1.43-2.01 and p = 0.041; OR = 1.52, 95% CI = 1.24-2.35, respectively).Conclusion: This research suggests, for the first time, that the ADIPOR1 rs2275738 "CC" genotype is associated with a 107% increased risk for biopsy-proven NAFLD.