OBJECTIVES: The development of fundic gland polyps (FGPs) is the most common side effect of long-term proton pump inhibitor (PPI) use; however, the effect of drug use characteristics and their impact on the risk of other gastric polyp development remain unclear. We aimed to identify the influence of PPI administration, as well as its duration and dose, in the development of gastric polyps. METHODS: A prospective cohort study was conducted on consecutive patients who underwent gastroscopy between September 2017 and August 2019. Detailed characteristics of gastric polyps, Helicobacter pylori infection, and PPI use were analyzed. RESULTS: Among the 2723 patients included, gastric polyps (75% FGPs, 22% hyperplastic) were detected in 16.4%, and 60% were prescribed PPI. The risk of FGPs and hyperplastic polyps according to the duration of PPI use were as follows: 2-5 years [odds ratio (95% confidence interval); 2.86 (2.00-4.11) and 2.82 (1.69-4.78)]; 6-9 years [7.42 (5.03-11.01) and 2.32 (1.05-4.78)]; ≥10 years [14.94 (10.36-21.80) and 3.52 (1.67-7.03)]. Multivariate analysis confirmed that the risk of FGPs was 17.16 (11.35-26.23) for ≥10 years of PPI use. Portal hypertension-related conditions were associated with hyperplastic polyps [4.99 (2.71-9.20)]. CONCLUSION: Duration of and indications for PPI use are the most predictive factors for the development of gastric polyps. Prolonged PPI use increases the risk of polyp development and the number of patients with polyps, which may burden endoscopic practice. Highly selected patients may require particular care despite minimal risk of dysplasia and bleeding generally.

• MeSH
• Adenomatous Polyps MeSH
• Gastroscopy MeSH
• Helicobacter pylori * MeSH
• Helicobacter Infections * complications   drug therapy   MeSH
• Proton Pump Inhibitors adverse effects   MeSH
• Humans MeSH
• Stomach Neoplasms * chemically induced   epidemiology   complications   MeSH
• Polyps * chemically induced   epidemiology   complications   MeSH
• Prospective Studies MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Names of Substances
• Proton Pump Inhibitors MeSH

BACKGROUND AND AIMS: Gastric adenocarcinoma and proximal polyposis of the stomach (GAPPS) has to date been recognized in only 8 families worldwide. Recently, different point mutations within the Ying Yang 1 (YY1) binding motif in promoter 1B of the APC gene were assigned as causal in 6 families with GAPPS. METHODS: We diagnosed GAPPS across 3 generations in a Czech white family. RESULTS: The proband's mother died of gastric cancer at 49 years of age. The proband died of gastric cancer at 56 years of age. All 3 of the proband's daughters inherited polyposis, involving exclusively the gastric fundus and body, with relative sparing of the lesser curve. The daughters have all been regularly surveyed endoscopically. Polyposis progressed rapidly with intestinal differentiated low-grade and high-grade dysplasia present on polypectomy specimens 5 years after the original diagnosis. On this basis, all 3 of the proband's daughters were scheduled for prophylactic total gastrectomy. Unfortunately, the middle daughter presented with generalized gastric adenocarcinoma and died at the age of 26 years. The other 2 daughters (aged 30 and 23 years) underwent total gastrectomy within 6 weeks of their sister's death; histology of surgical specimens showed gastric adenocarcinoma stage IA (pT1a, N0, M0) in both cases. Bi-directional Sanger sequencing of promoter 1B revealed a point mutation (c.-191 T>C) in all 3 daughters of the proband. CONCLUSIONS: Atypical endoscopic progression of the fundic gland polyposis, with the presence of dysplasia on polypectomy specimens and genetic testing with recently discovered mutations in promoter 1B of the APC gene might help clinicians to decide whether prophylactic gastrectomy should be performed.

• MeSH
• Adenocarcinoma complications   genetics   prevention & control   MeSH
• Adenomatous Polyps complications   genetics   pathology   surgery   MeSH
• Adult MeSH
• Gastrectomy MeSH
• Gastroscopy MeSH
• Genes, APC * MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Mutation MeSH
• Stomach Neoplasms complications   genetics   pathology   prevention & control   surgery   MeSH
• Polyps complications   genetics   pathology   surgery   MeSH
• Promoter Regions, Genetic MeSH
• Pedigree MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Case Reports MeSH
• Review MeSH

OBJECTIVES: Endometrial polyps (EPs) are among the common cases of abnormal uterine bleeding. Hormonal factors may be involved in the pathogenesis as indicated by endometrial abnormalities in patients treated with tamoxifen. This study was designed to analyse the patient characteristics which may be associated with polyp occurrence and assess the diagnostic and therapeutic difficulties. Group of 245 patients was formed to 152 postmenopausal and 93 premenopausal women with EP diagnosed hysteroscopically and confirmed histologically. Evaluated factors were as follows: 1) patient characteristics: age, body mass, systemic hypertension, diabetes mellitus, nulliparity, late menopause, estrogen replacement therapy, and tamoxifen treatment; 2) clinical features of EPs, and 3) the number of curettage's (D & C) and hysteroscopies. RESULTS: Hypertension associated with obesity appears to be an important factor in combination which may play role in the pathogenesis of EPs like the late menopause which was noted in 30% of examined postmenopausal women. An association between EPs and tamoxifen was found in 8% patients with breast cancer. 2. Postmenopausal uterine bleeding and menstrual disorders were prominent clinical symptoms in 44% post- and in 82% of premenopausal women. The other 56% post- and 18% premenopausal patients were asymptomatic. 3. The multiple EPs were present in 26% of postmenopausal and in 15% premenopausal women. 4. Transvaginal ultrasonography supplemented by sonohysterography in cases with abnormal ultrasonographic findings should be the main diagnostic method. 5 Hysteroscopical polypectomy is regarded as the optimal therapy and the removal of the endometrial basalis in the EP origin area prevents persistence or recurrence of EP.

• MeSH
• Uterine Hemorrhage complications   epidemiology   MeSH
• Diabetes Mellitus epidemiology   MeSH
• Adult MeSH
• Hormone Replacement Therapy adverse effects   MeSH
• Hypertension complications   epidemiology   MeSH
• Hysteroscopy MeSH
• Diabetes Complications MeSH
• Middle Aged MeSH
• Humans MeSH
• Endometrial Neoplasms complications   diagnosis   epidemiology   therapy   MeSH
• Obesity complications   epidemiology   MeSH
• Parity MeSH
• Polyps complications   diagnosis   epidemiology   therapy   MeSH
• Postmenopause MeSH
• Premenopause MeSH
• Prospective Studies MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Age Factors MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Clinical Trial MeSH

Fibroepithelial polyps of the ureter are rare. They have as a rule a benign character and threaten the patient by obstruction of the efferent urinary pathways. The author presents an account in Olomouc. In the discussion he deals with the problem of diagnosis and treatment of this disease.

• MeSH
• Adult MeSH
• Fibroma complications   surgery   MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Ureteral Neoplasms complications   surgery   MeSH
• Ureteral Obstruction etiology   MeSH
• Polyps complications   surgery   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Female MeSH
• Publication type
• English Abstract MeSH
• Journal Article MeSH
• Case Reports MeSH

• MeSH
• Child MeSH
• Hydronephrosis etiology   MeSH
• Kidney Pelvis MeSH
• Humans MeSH
• Kidney Neoplasms complications   MeSH
• Ureteral Neoplasms complications   MeSH
• Polyps complications   MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Male MeSH
• Publication type
• Journal Article MeSH
• Case Reports MeSH

• MeSH
• Asthma diagnosis   MeSH
• Diagnostic Errors * MeSH
• Diagnosis, Differential MeSH
• Child MeSH
• Dyspnea etiology   MeSH
• Infant MeSH
• Humans MeSH
• Bronchial Neoplasms complications   diagnosis   MeSH
• Polyps complications   diagnosis   MeSH
• Child, Preschool MeSH
• Inflammation MeSH
• Check Tag
• Child MeSH
• Infant MeSH
• Humans MeSH
• Child, Preschool MeSH
• Female MeSH
• Publication type
• English Abstract MeSH
• Journal Article MeSH
• Case Reports MeSH

• MeSH
• Time Factors MeSH
• Uterine Hemorrhage etiology   MeSH
• Gestational Age MeSH
• Pregnancy Complications etiology   MeSH
• Humans MeSH
• Uterine Cervical Neoplasms complications   MeSH
• Polyps complications   MeSH
• Pregnancy MeSH
• Check Tag
• Humans MeSH
• Pregnancy MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Case Reports MeSH

• MeSH
• Asphyxia Neonatorum etiology   MeSH
• Humans MeSH
• Pharyngeal Neoplasms complications   congenital   pathology   MeSH
• Infant, Newborn MeSH
• Polyps complications   congenital   pathology   MeSH
• Hair MeSH
• Check Tag
• Humans MeSH
• Infant, Newborn MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

• MeSH
• Cholelithiasis surgery   MeSH
• Cholestasis etiology   MeSH
• Adult MeSH
• Endoscopy MeSH
• Calculi complications   MeSH
• Humans MeSH
• Bile Duct Neoplasms complications   MeSH
• Liver Diseases complications   MeSH
• Gallbladder Diseases surgery   MeSH
• Polyps complications   MeSH
• Bile Ducts, Intrahepatic * surgery   MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Male MeSH
• Publication type
• Journal Article MeSH