In this study, we aimed to assess the cancer risk among patients with periodontal disease. Patients diagnosed with periodontal diseases at Hacettepe University between 2007 and 2012 were included and data on the diagnosis of any cancer after periodontal disease were collected from patient files. The age- and sex-standardized incidence rates (SIRs) were calculated using Turkish National Cancer Registry 2013 data. A total of 5199 patients were included. Median follow-up was 7.2 years. Patients with periodontal diseases had 17% increased risk of cancer compared with the expected counts for the corresponding age and sex groups (SIR: 1.17; 95% CI: 1.04–1.3, P = 0.006). The increased cancer risk was statistically significant in women (SIR: 1.24; 95% CI: 1.05–1.45, P = 0.008) but not in men. Among women with periodontal disease, the risks of breast cancer (SIR: 2.19) and head and neck cancer (SIR: 4.71) were significantly increased. Among men, the risks of prostate cancer (SIR: 1.84), head and neck cancer (SIR: 3.55), and hematological cancers (SIR: 1.76) were significantly increased. This study showed that periodontal diseases were associated with increased risk of several cancers. Besides other well-known benefits for health, the provision of oral/dental health should be considered and employed as a cancer prevention measure.

Background: Irritable bowel syndrome is accepted as a functional disorder; however, there is growing evidence in favor of the inflammatory process contributing to its pathogenesis. We aimed to evaluate the role of the systemic immune-inflammation index as a marker of inflammation in patients with irritable bowel syndrome. Methods: The study was conducted in the outpatient clinic of the Gastroenterology Department with patients having constipationpredominant irritable bowel syndrome diagnosis according to Rome IV criteria between March 1, 2019 and December 31, 2020. The systemic immune-inflammation index was calculated and compared with age- and sex-matched healthy controls. Results: The study was performed with 214 participants, 107 patients and 107 control groups. Platelet and neutrophil counts (P < .001, for both) were higher, and lymphocyte count (P = .003) was lower in the irritable bowel syndrome group. The systemic immune-inflammation index was higher in irritable bowel syndrome patients (P < .001). Multivariate logistic regression analyses showed the role of the systemic immune-inflammation index as an independent predictor of the presence of IBS (odds ratio: 1.100, P < .001). Conclusion: Systemic immune-inflammation index may be a cheap, universal, and reliable indicator of the inflammatory process in irritable bowel syndrome patients.

An intraluminal duodenal diverticulum is a rare congenital anomaly stemming from incomplete duodenal lumen formation during embryogenesis [1] [2] [3] [4] [5]. Over time, the remnant duodenal diaphragm resembles a windsock by elongation secondary to intestinal peristaltic movements [1] [2] [3]. In most patients, the condition is detected incidentally [1] [2]. However, a few patients may present in adulthood with symptoms of partial duodenal obstruction, such as early satiety, vomiting, and abdominal pain [1] [2]. Rare bleeding and pancreatitis may complicate the scenario [1] [2]. Herein we present a case treated with endoscopic intraluminal diverticulectomy ([Fig. 1]). A 20-year-old woman with no previous medical history presented with complaints of early satiety and postprandial vomiting for 5 years. Symptoms had intensified in the last 6 months. An upper gastrointestinal endoscopy revealed a diverticulum at the intersection of the first and second parts of the duodenum, which extended distally in the form of a funnel, resembling a windsock. There was an orifice in its dome that did not allow the passage of the endoscope. The diverticulum was undulating and freely inverted with aspiration. Computed tomography supported the diagnosis of an intraluminal duodenal diverticulum ([Fig. 2]). Subsequently, the patient underwent endoscopic diverticulectomy with an EG-530 D dual-channel endoscope (Fujifilm, Tokyo, Japan). A polypectomy snare was opened in the duodenal lumen proximal to the diverticulum. Forceps inserted via the second working channel were passed through the snare. The orifice at the diverticular dome was grasped and pulled into the snare that connected to the electrosurgical unit, and the diverticulectomy was performed in “Force-Coag-2” mode in two stages ([Video 1]). No complications such as bleeding or perforation occurred. Adrenalin injection and hemoclips were applied to the edges of the newly created opening ([Fig. 3]). The patient has been symptom-free for 1 month. Video 1 A rare case of a windsock-shaped intraluminal duodenal diverticulum treated successfully with endoscopic diverticulectomy. In conclusion, an intraluminal duodenal diverticulum should be included in the differential diagnosis in patients with duodenal stenosis and complaints such as early satiety and vomiting. Endoscopic diverticulectomy is an effective and safe treatment option for an intraluminal duodenal diverticulum. Endoscopy_UCTN_Code_TTT_1AO_2AN Article published online: 01 July 2022 © 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/) Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany