Minerva Surgery最新文献

Introduction: Esophageal inflammatory fibroid polyp (IFP) is a rare benign tumor of the gastrointestinal tract with limited available data on clinicopathologic features and treatment strategies.

Evidence acquisition: A systematic review of the literature in PubMed/Medline and Scopus databases was performed for articles concerning esophageal IFP in adult population.

Evidence synthesis: A total of 16 studies were identified, involving 16 patients with a Male-Female Ratio of 3:1 and mean age of 50.38 years. Clinical presentation of esophageal IFP included progressive dysphagia in 56.3% of cases, with additional symptoms such as epigastric and retrosternal pain, weight loss, vomiting, and melena. Diagnostic modalities involved endoscopy in all cases, with endoscopic ultrasound (EUS) employed in 50% of cases and tissue biopsy performed during endoscopy in 87.5% of the patients. Therapeutic approach of esophageal IFP consisted of surgical resection in 75% of the patients and endoscopic resection in the remaining 25%, with various surgical procedures employed based on tumor location. Follow-up data, available for 11 patients over a median duration of 15.5 months, indicated two instances of recurrence following endoscopic resection, while the other nine patients remained asymptomatic with no evidence of recurrence.

Conclusions: Esophageal IFP is a rare benign tumor of the gastrointestinal tract presenting with dysphagia, regurgitation, and heartburn. Resection, either endoscopic or surgical, is the primary treatment approach. Prognosis for esophageal IFP is favorable, with low recurrence rates. Further research is required to investigate potential risk factors and etiology for this lesion, and to explore novel therapeutic approaches that may improve patient outcomes.

Background: The aim of this registry study was to evaluate the effects of Pycnogenol^® and Centellicum^® (PYCE) on skin perfusion and skin elasticity in healthy women over a period of 4 weeks.

Methods: The supplemented women used 150 mg of Pycnogenol^® and 450 mg of Centellicum^® daily. The supplemented group used the combination PYCE daily for 4 weeks and followed the standard management (SM) in addition. A control group used only the SM. SM for all subjects included a healthy diet (low levels of NaCl, low sugar, low calories), vitamin supplementation (C, E, B), daily mild outdoors exercise, regular washing with neutral soap; the same non-clinical, non-specific hydrating cream (Nivea) was used once daily.

Results: Sixty-three women completed the registry study. Thirty women using the PYCE combination and 33 women in the control group. The groups were comparable at baseline. No clinical condition was observed during the registry; no drug was used. There were no side effects or tolerability problems with the supplements. After 4 weeks, ultrasound elastosonography showed that skin elasticity significantly improved with the PYCE combination (P<0.05) without significant changes in the control group. In parallel, transcutaneous skin PO2 increased significantly with PYCE compared to controls and transcutaneous skin PCO2 decreased significantly compared to controls (P<0.05). This showed that skin oxygenation and nutrition improved with PYCE. Skin hydration also significantly improved with PYCE (P<0.05) in comparison with controls. Skin flow, indicating skin blood perfusion (thermoregulatory flow), assessed by laser Doppler flowmetry significantly improved over 4 weeks compared to controls (P<0.05). More specifically, the most superficial part of the flow, in the most superficial layer of the skin, corresponding to the nutritional blood flow, significantly improved with the combination PYCE compared to controls (P<0.05). Skin and tissue elasticity are crucial in surgery for healing, scarring, and wound closure. Reduced elasticity can lead to irregular or delayed healing. This preliminary concept study suggests that PYCE supplementation enhances skin elasticity, perfusion, and nutrition, with visible effects seen in just 4 weeks.

Conclusions: This preliminary, concept study indicates that skin elasticity, skin perfusion, and skin nutrition improved with the supplementation of PYCE and the effects of PYCE were visible after only 4 weeks. A longer observation period should be considered in future studies. In conclusion, this pilot concept study shows a significant activity of the combination Pycnogenol^® and Centellicum^® on skin elasticity over a short period of supplementation.