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Surg Today ; 52(2): 231-238, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1318762


PURPOSES: The spread of coronavirus disease 2019 (COVID-19) has affected socioeconomic and healthcare systems in many countries. Accordingly, many individuals may have canceled their annual health-check programs, including esophagogastroduodenoscopy, which would have resulted in lower numbers of newly diagnosed patients with gastric cancer in comparison to other times. METHODS: Questionnaires were distributed to 62 hospitals every week from May 2020 to August 2020 (total 744) through mailing lists of the Stomach Cancer Study Group of the Japan Clinical Oncology Group. The number of patients with gastric cancer and hospital systems during the COVID-19 pandemic were surveyed. RESULTS: In total, 74% (551 out of 744) of the questionnaires were answered and analyzed. In early May, approximately 50% of hospitals had to restrict surgical slots due to the COVID-19 pandemic. However, they gradually loosened the restrictions thereafter. The number of gastrectomies was < 80% that of the same period in the previous year, and hospitals in Tokyo were seriously affected by a 50% decrease in the number of gastrectomies. CONCLUSIONS: The number of gastrectomies was lower than that in the previous year. Further multi-center follow-up studies are required to evaluate the long-term effects of COVID-19 on the clinical outcomes of patients with gastric cancer.

COVID-19/epidemiology , Delivery of Health Care/organization & administration , Hospitals, High-Volume/statistics & numerical data , Infection Control/organization & administration , Stomach Neoplasms/diagnosis , Stomach Neoplasms/therapy , COVID-19/prevention & control , COVID-19/transmission , Endoscopy, Digestive System/statistics & numerical data , Facilities and Services Utilization , Gastrectomy/statistics & numerical data , Humans , Japan , Procedures and Techniques Utilization , Stomach Neoplasms/epidemiology , Surveys and Questionnaires
Eur J Gastroenterol Hepatol ; 33(1S Suppl 1): e1051-e1056, 2021 12 01.
Article in English | MEDLINE | ID: covidwho-1242125


Gut involvement is frequent in immunologic disorders, especially with inflammatory manifestations but also with cancer. In the last years, advances in functional and genetic testing have improved the diagnostic and therapeutic approach to immune dysregulation syndromes. CTLA-4 deficiency is a rare disease with variable phenotype, ranging from absence of symptoms to severe multisystem manifestations and complications. We describe a rare case of CTLA-4 deficiency in a boy with gastric cancer, very early onset inflammatory bowel disease and polyautoimmunity, the second-ever reported in the literature with the same characteristics. A 17-year-old boy was referred to Bambino Gesù Children's Hospital of Rome, a tertiary care center, for a gastric mass and a long-term history of very early onset inflammatory bowel disease, diabetes mellitus type 1, polyarthritis and psoriasis. Histology of gastric biopsies revealed the presence of neoplastic signet ring cells. Imaging staging showed localized cancer; therefore, the patient underwent subtotal gastrectomy with termino-lateral gastro-jejunal anastomosis. Immunological work up and genetic testing by next-generation sequencing panels for primary immunodeficiencies led to the diagnosis of CTLA-4 deficiency. Good disease control was obtained with the administration of Abatacept. The patient experienced an asymptomatic SARS-CoV-2 infection without any concern. Eighteen months after treatment initiation, the patient is alive and well. Immunologic and genetic testing, such as next-generation sequencing, should always be part of the diagnostic approach to patients with complex immune dysregulation syndrome, severe clinical course, poor response to treatments or cancer. The early recognition of the monogenic disease is the key for disease management and targeted therapy.

Abatacept/therapeutic use , Autoimmune Diseases , CTLA-4 Antigen/deficiency , Inflammatory Bowel Diseases , Stomach Neoplasms , Adolescent , Asymptomatic Infections , Autoimmune Diseases/diagnosis , Autoimmune Diseases/drug therapy , Autoimmune Diseases/genetics , COVID-19 , CTLA-4 Antigen/genetics , Humans , Inflammatory Bowel Diseases/diagnosis , Inflammatory Bowel Diseases/drug therapy , Inflammatory Bowel Diseases/genetics , Male , Stomach Neoplasms/diagnosis , Stomach Neoplasms/drug therapy , Stomach Neoplasms/genetics
Dig Liver Dis ; 52(7): 695-699, 2020 07.
Article in English | MEDLINE | ID: covidwho-277040


We conducted a survey to investigate to what extent the fear of COVID-19 has influenced the patients decision to undergo or to cancel endoscopic procedures. We collected data from 847 patients from 13 centres. The main indication for endoscopy was anemia, followed by pain and unexplained weight loss. The percentage of not presenters progressively increased throughout the three weeks of study, from 15.1% at the beginning to 48.2% at the end. 37 (34.2%) upper GI endoscopies and 112 (56.3 %) colonoscopies showed an organic cause explaining the symptoms presented by the patients, respectively; 5 cases of gastric cancer (4.6%) and 16 cases of colorectal cancer (CRC) (6.0%), respectively, were detected; during the second week the percentage of organic diseases found at upper endoscopy was 19 (33.3%) with 5 cancer (8.7%), and 61 (49.1% ) at colonoscopy, with 2 CRC (1.6%); finally, during the third week the corresponding figures were 19 (48.7%) for upper GI examinations, with 3 gastric cancers (7.7%), and 43 (60.5%) with 4 (6.5%) CRC cases found.We conclude that patients weighted the fear of having a clinically relevant disease with the fear of becoming infected by coronavirus, and a relevant percentage of them (29.4%) decided not to attend the endoscopy suites at the scheduled date.

Colorectal Neoplasms , Coronavirus Infections , Endoscopy, Gastrointestinal , Fear , No-Show Patients , Pandemics , Pneumonia, Viral , Stomach Neoplasms , Attitude to Health , Betacoronavirus/isolation & purification , COVID-19 , Colorectal Neoplasms/diagnosis , Colorectal Neoplasms/epidemiology , Colorectal Neoplasms/physiopathology , Colorectal Neoplasms/psychology , Coronavirus Infections/epidemiology , Coronavirus Infections/psychology , Coronavirus Infections/transmission , Disease Outbreaks , Endoscopy, Gastrointestinal/psychology , Endoscopy, Gastrointestinal/statistics & numerical data , Female , Humans , Italy/epidemiology , Male , Middle Aged , No-Show Patients/psychology , No-Show Patients/statistics & numerical data , Outcome Assessment, Health Care , Pneumonia, Viral/epidemiology , Pneumonia, Viral/psychology , Pneumonia, Viral/transmission , SARS-CoV-2 , Stomach Neoplasms/diagnosis , Stomach Neoplasms/epidemiology , Stomach Neoplasms/physiopathology , Stomach Neoplasms/psychology , Surveys and Questionnaires