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Helicobacter pylori (H. pylori) remains the most-researched etiological factor for gastric inflammation and malignancies. Its evolution towards gastric complications is dependent upon host immune response. Toll-like receptors (TLRs) recognize surface and molecular patterns of the bacterium, especially the lipopolysaccharide (LPS), and act upon pathways, which will finally lead to activation of the nuclear factor-kappa B (NF-kB), a transcription factor that stimulates release of inflammatory cytokines. MicroRNAs (MiRNAs) finely modulate TLR signaling, but their expression is also modulated by activation of NF-kB-dependent pathways. This review aims to focus upon several of the most researched miRNAs on this subject, with known implications in host immune responses caused by H. pylori, including let-7 family, miRNA-155, miRNA-146, miRNA-125, miRNA-21, and miRNA-221. TLR–LPS interactions and their afferent pathways are regulated by these miRNAs, which can be considered as a bridge, which connects gastric inflammation to pre-neoplastic and malignant lesions. Therefore, they could serve as potential non-invasive biomarkers, capable of discriminating H. pylori infection, as well as its associated complications. Given that data on this matter is limited in children, as well as for as significant number of miRNAs, future research has yet to clarify the exact involvement of these entities in the progression of H. pylori-associated gastric conditions.

Non-invasive biomarkers, such as neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios, may predict inflammation in various disorders, including gastritis, according to recent data. Nevertheless, various studies reported an association between Helicobacter pylori ( H pylori ) and immune thrombocytopenia in both adults and pediatric patients. The objective of our study was to evaluate the impact of pediatric gastritis, caused or not by H pylori infection on erythrocytes, their parameters, thrombocytes, mean platelet volume, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). We performed a prospective, case–control study on 151 patients aged between 1 and 17 years who presented with chronic dyspeptic symptoms. An upper digestive endoscopy with gastric biopsies and a complete blood count was performed in each case. Control group consisted of 67 patients with normal histological findings, while the two study groups were divided into group 1— H pylori -induced gastritis (31 patients) and group 2—non- H pylori- induced gastritis (53 patients). Children from the rural area were more likely to develop both types of gastritis ( P < .01). No significant difference was found between either of the study groups and control group in terms of platelets, mean platelet volume, NLR and PLR ( P > .05). However, significantly higher values of lymphocytes were associated with non- H pylori -induced gastritis ( P < .01). Comparison of the two study groups did not reflect any significant differences in terms of hematological parameters. When assessing these constants in relation to gastritis severity, severe gastritis led to a compelling decrease in hemoglobin (Hb) and hematocrit (Htc) levels. The comparison of parameters between severe, moderate, and mild gastritis did not reveal any significant results. Childhood and adolescent gastritis does not produce a significant effect upon platelet counts, their mean volume, PLR or NLR, according to our study. An important increase in lymphocyte count might predict non- H pylori pediatric gastritis. Moreover, severe gastritis might result in an important decrease in Hb and Htc levels.

MULTIPLE COLONIC AND GASTRIC METASTASIS OF ENDOMETRIAL ADENOCARCINOMA -CASE REPORT (Abstract): INTRODUCTION:In the gynecological malignancies endometrial adenocarcinoma is the second most common, giving early hematogenous and lymphatic metastasis to the lungs, brain and bones. CASE REPORT: We present the case of a 71 year old patient who underwent surgery two years ago for endometrial adenocarcinoma and followed postoperatively multimodal oncological treatment. The patient was admitted in January 2013 in the First Surgery Clinic of the Emergency Clinical County Hospital Târgu Mureş, Romania, for chronic anemia, consumptive disease signs and subocclusive syndrome. The preoperative exams (upper and lower gastrointestinal endoscopy, thoracoabdominal computed tomography and ultrasound) found a tumor invading right, transverse and sigmoid colon as well as gastric antrum and spleen. A subtotal colectomy with ileo-rectal anastomosis was then performed associated with distal gastrectomy and splenectomy. The histopathological exams revealed gastric and colonic metastasis from the endometrial serous cancer operated two years ago. The postoperative evolution was uneventful. CONCLUSIONS: Endometrial cancer can metastasize to the colon and stomach even without the presence of endometriosis. Multivisceral resections and preoperative exams of the digestive tract are justified in terms of subjective complaints of an occlusive simptomatology.

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