Gastro Education

Nikolaos G Margetis graduated from University of Patras (Greece) in 1995. He has specialized in Gastroenterology since 2005 and Specialist in EUS since 2006. Since July 2017 he holds a PhD Degree from Medical School of National and Kapodistrain University of Athens, Greece. He has been a Consultant in three Great Hospitals of Athens. He was a Member of SOS DOCTORS of Athens for six years. Since 2013 he is a Member of Athens University (belongs to the Molecular Carcinogenesis Group and teaches the undergraduate and postgraduate students of the Medical and the Nursing Schools). He has 10 publications in reputed international medical journals, 30 publications in greek medical journals and has contributed in 2 Greek Medical textbooks’ writing. He is the Editorial Board Member in 4 and Reviewer in 3 international medical journals with authority. He was awarded for his work in two congresses and in many hands-on courses. He organized the 1st Greek Congress “Georgios Papanicolaou-The prevention of cancer”.\r\n\r\n

MicroRNAs are non-coding RNA molecules, inhibiting or abrogating the translation process of their mRNA target. Let-7 is the prototypical microRNA family. Thirteeen precursor transcripts are processed and generate ten mature let-7 members. Nevertheless, mature and precursor let-7 molecules are produced in distinct rates throughout carcinogenesis process. This differentiated expression may contribute in the genetic regulation of many cancers, including gastrointestinal ones. The mission of let-7 in the gastrointestinal tract and in both liver/pancreas is to promote differentiation and to depress stemness. Although scarce reports imply its oncogenecity, let-7 is widely considered a tumor-suppressor gene, as it downregulates every single hallmark of cancer. Let-7 targets a plentitude of crucial oncogenes (K-ras, c-myc) and in a lesser degree, tumor-suppressor genes or tumor-suppressive pathways (p53, Wnt/APC). K-ras oncogene, the most prevalent oncogenic driver mutation in colorectal and pancreatic cancer, is the dominant target of let-7. The interplay between let-7 and its effectors is complex, as approximately all let-7 targets behave as its reciprocal regulators, mainly negative. Moreover, let-7 is autoregulated (positively or negatively), and it depends its effect either on other miRNAs or on dietary compounds. Despite the well-documented pathogenetic, prognostic, predictive, diagnostic and therapeutic role of let-7 in colorectal cancer, recent research has documented its crucial role in the epigenetic regulation of other gastrointestinal cancers as well, as those of pancreas, liver, stomach and esophagus. The aim of this e-poster presentation is to outline the current data regarding the role of let-7 in the tumor-suppressive circuits of several gastrointestinal tumorigenesis processes.\r\n\r\n

Rene M Gordillo, a General and Laparoscopic Surgeon graduated from the International University of Ecuador, Ecuador; pursued Diploma in Advanced Laparoscopy from the Pontifical Catholic University of Chile, Chile. He is a Fellow of the American College of Surgeons. He has to his credit: Certification in Trauma Surgery Management from the University Hospital del Valle de Cali – Colombia; Certification in Bariatric Surgery and Hepatic, Biliary and Pancreatic Surgery by IRCAD of Brazil; Fellow in Minimally Access Thyroidectomy in Thailand. He is the Head of Emergency and Trauma Service at Hospital IESS IBARRA and Head of the Surgery Service of the General Hospital of the Ecuadorian Institute of Social Security (IESS) of Ibarra in Ecuador. He is also the main Surgeon in private institutions such as medical specialties institute and Nova Clínica Moderna.

Endoscopic thyroidectomy performed by the transoral approach is currently the newest method and one that has unleashed the most curiosity in the world. Ten years after having been described in pigs and then in human cadavers is already being done in all continents, even by small and isolated groups, however thanks to international forums, learning and social networks has spread the technique and nowadays there are more surgeons interested in their learning. The main feature is that this surgery can be performed totally without scars if we compare it with the usual technique described by Theodoro Kocher, and even with video-assisted techniques and remote approach described in the last 20 years. While its description was made by Dr. K Witzel in 2008, was Dr. Angkoon Anunwong who popularized it by publishing his first series on humans in the world. At the moment it is realized in several countries around the world and although it still has a high casuistry, it has given a lot of that to speak by its kindnesses. Another important feature is that in order to perform this surgery, it is not necessary to use special is instrumental and equipment, but only basic laparoscopic instruments are used. So far in all series have not reported cases of recurrent laryngeal nerve injury or permanent hypocalcemia; is that in endoscopic vision we have an excellent view of both the recurrent laryngeal nerve and the parathyroid glands, even some groups are supported by neuromonitoring of the nerve and even with augmented reality with fluorescence to identify the parathyroid glands.

Hassan Moteirek pursued his MD Degree in 2003 at the Belarussian State Medical University in Minsk, Belarus and continued his education and training in the Gastrointestinal and Endoscopy Department. He is also currently working at Nabatiye, center Berjawi,Lebanon

Crohns disease in patients with VW (Von Willebrand) disease may have recurrent complications mostly related to bleeding disorder especially if the patient wasn\'t well prepared with the appropriate factors such as VWF, before procedures such as colonoscopy. Here i am to share a case with severe ileal bleeding after biopsy in a 28 years old patient with Crohns disease; this patient was admitted with Ht 42 and after severe bleeding it dropped to 22, neither injection, nor argon or clipping were helpful to perform hemostasis, his PTT was slightly elevated, he denied any history of bleeding disorders, no treatment could help so we went for surgery. After 72 hours again he started to see fresh blood, at this time we got the results for bleeding factors and so it was factor VIII deficiency secondary to VWF deficiency. And we started treatment with VW factor for 10/days and the patient survived.