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Tissue biopsy remains the standard for diagnosing gastrointestinal stromal tumors (GISTs), although liquid biopsy is emerging as a promising alternative in oncology. In this pilot study, we advocate for droplet digital PCR (ddPCR) to diagnose GIST in tissue samples and explore its potential for early diagnosis via liquid biopsy, focusing on the PDGFRA D842V mutation and SEPT9 hypermethylated gene. We utilized ddPCR to analyze the predominant PDGFRA mutation (D842V) in surgical tissue samples from 15 GIST patients, correlating with pathologists' diagnoses. We expanded our analysis to plasma samples to compare DNA alterations between tumor tissue and plasma, also investigating SEPT9 gene hypermethylation. We successfully detected the PDGFRA D842V mutation in GIST tissues by ddPCR. Despite various protocols to enhance mutation detection in early-stage disease, it remained challenging, likely due to the low concentration of DNA in plasma samples. Additionally, the results of Area Under the Curve (AUC) for the hypermethylated SEPT9 gene, analyzing concentration, ratio, and abundance were 0.74 (95% Confidence Interval (CI): 0.52 to 0.97), 0.77 (95% CI: 0.56 to 0.98), and 0.79 (95% CI: 0.59 to 0.99), respectively. As a rare disease, the early detection of GIST through such biomarkers is particularly crucial, offering significant potential to improve patient outcomes.

Introduction: Antireflux surgery is commonly associated with significant recurrence and complication rates, and several surgical techniques have been proposed to minimize them. The aim of this study is to evaluate the results of a fundoplication with extensive dissection of the esophagogastric junction 1 and 3 years after the procedure., Methods: Retrospective observational study including 178 patients with gastroesophageal reflux disease or hiatal hernia who underwent fundoplication with extensive dissection of the esophagogastric junction between 2015 and 2020. Hernia recurrence, symptoms and quality of life at 1 and 3 years after surgery were assessed by barium transit, endoscopy and questionnaires for symptoms and quality of life (GERD-HRQL)., Results: Heartburn rate was 7.5% and 10.7% at 1 and 3 years respectively, regurgitation 3.8% and 6.9% and dysphagia was 3.7% and 7.6%. The presence of hiatal hernia was evident preoperatively in 55.1% and in 7.8% and 9.6% at follow-up and the median GERD-HRQL scale was 27, 2 and 0 respectively. There were no cases of slippage of the fundoplication or symptoms suggestive of vagal injury. No differences were found when comparing the different types of fundoplication in terms of reflux and recurrence or complications., Conclusions: Fundoplication with extensive dissection of the esophagogastric junction contributes to correct positioning and better anchorage of the fundoplication, which is associated with low rates of hiatal hernia and reflux recurrence, as well as absence of slippage and lower possibility of vagal injury., (Copyright © 2023 AEC. Published by Elsevier España, S.L.U. All rights reserved.)

Objective: To estimate the association between childhood obesity and the risk of SARS-CoV-2 infection in a cohort followed from 4 to 12 years of age., Methods: The data were obtained from two independent sources: the Longitudinal Childhood Obesity Study (ELOIN) and the epidemiological surveillance system data from the Community of Madrid (Spain), which served to identify the population within the cohort with confirmed SARS-CoV-2 infection. The SARS-CoV-2 registry was cross-checked with the cohort population at 11-12 years of age. A total of 2018 eligible participants were identified in the cohort, who underwent physical examinations at 4, 6, and 9 years of age during which weight, height, and waist circumference were recorded. General obesity (GO) was determined according to the WHO-2007 criteria whereas abdominal obesity (AO) was defined based on the International Diabetes Federation (IDF) criteria. The relative risks (RRs) of infection were estimated using a Poisson regression model and adjusted by sociodemographic variables, physical activity, and perceived health reported by the parents., Results: The accumulated incidence of SARS-CoV-2 infection was 8.6% (95% CI: 7.3-9.8). The estimated RR of SARS-CoV-2 infection was 2.53 (95% CI: 1.56-4.10) and 2.56 (95% CI: 1.55-4.21) for children 4-9 years old with stable GO and AO, respectively, compared with those who did not present GO., Conclusions: Childhood obesity is an independent risk factor for SARS-CoV-2 infection. This study provides new evidence that indicates that obesity increases the vulnerability of the paediatric population to infectious diseases., (© 2022. The Author(s), under exclusive licence to Springer Nature Limited.)

Background: Up to 22% of the patients, after laparoscopic Roux-en-Y gastric bypass (LRYGB) can complain about gastroesophageal reflux disease (GERD) symptoms, there is little evidence about the most effective treatment of this situation., Materials and Method: This video shows a laparoscopic reintervention after a LRYGB in a 42-year-old woman presenting with untreatable GERD. GERD was treated with maximum doses of PPIs with no effect on the symptoms; the patient had a 24-h pH and impedance manometry that showed an acid and non-acid reflux, and for that reason, we decided to perform a laparoscopic fundoplication. First, very dense adhesions of the greater omentum and the stomach to the parietal peritoneum and the left lobe of the liver are dissected. The gastric remnant is dissected from the pouch, and as the adhesions are very hard, we use a linear stapler device to definitely separate remnant from the pouch, then, short gastric vessels are taken down, to allow mobilization to the medial side of the patient, being careful to preserve the dorsal gastric artery branch of the splenic artery. A Toupet fundoplication is performed with the gastric remnant, and a crural repair is performed with Ethibond stitches reinforced with a polypropylene mesh., Results: After 1 year from the surgery, the patient is asymptomatic, with a normal pH metry and barium swallow., Conclusions: The laparoscopic fundoplication [1] after a LRYGB is one feasible surgical option intervention, but it must be performed with experienced hands and in a hospital with bariatric/esophagogastric surgery unit, in those patients with severe GERD after LRYGB and with no response to medical treatment.

This video shows a laparoscopic reintervention after an open, vertical banded gastroplasty in a 39-year-old woman presenting with untreatable GERD.

Objective: To determine the incidence of paclitaxel and docetaxel infusion-associated reactions, and the likely causes that may trigger them., Method: Cohort study of the paclitaxel and docetaxel infusions carried out at a tertiary hospital from July of 2010 to December of 2011 (18 months). For each infusion, the clinical data and the drug-related data were recorded. When a reaction occurred during the infusion the following data were specified: type, severity, if treatment withdrawal was needed. The clinical charts and treatment orders were reviewed. The follow-up of the infusions were done by contacting the day-care hospital nurses. A descriptive study was done for the most relevant variables included in the follow-up and we analyzed if any of them could have had an influence on the occurrence of the reactions., Results: During the study period, 357 paclitaxel and docetaxel infusions were administered to 92 patients: mean age 61.4 years (SD 11.1), 50.0% were female. 9 infusion reactions affecting 8 patients occurred, all of them caused by docetaxel (c2 = 8.3, p = 0.004); 14.5% of the patients receiving it, and always during the first or second treatment cycle. The variables significantly associated to the occurrence of the reaction were: lung cancer (p< 0.005), docetaxel-cisplatin regime (p< 0.005), receiving the drug as first line (p=0.021), and non-advanced disease (p = 0.014)., Conclusions: At our hospital, docetaxel is the taxane that has provoked the most frequent safety problems during the infusion., (Copyright © 2013 SEFH. Published by AULA MEDICA. All rights reserved.)

Fecundity, oviposition patterns and egg hatching characteristics were studied in two colonies of Anopheles albimanus isolated from the Pacific coast of southern Mexico. Fecundity was inversely proportional to the cage space available to the female and was influenced by the bloodmeal source, feeding method and previous feeding history. The length of the gonotrophic cycle decreased with succeeding experience from a mean 6.6 in the first to 2.6 days for the fifth cycle. Oviposition timing was also dependent on availability of oviposition substrate. Hatching success of eggs increased significantly when the oviposition site was witheld until 48 hr post-bloodmeal.