Viability study of machine learning-based prediction of COVID-19 pandemic impact in obsessive-compulsive disorder patients

Background: Machine learning modeling can provide valuable support in different areas of mental health, because it enables to make rapid predictions and therefore support the decision making, based on valuable data. However, few studies have applied this method to predict symptoms’ worsening, based on sociodemographic, contextual, and clinical data. Thus, we applied machine learning techniques to identify predictors of symptomatologic changes in a Spanish cohort of OCD patients during the initial phase of the COVID-19 pandemic. Methods: 127 OCD patients were assessed using the Yale–Brown Obsessive-Compulsive Scale (Y-BOCS) and a structured clinical interview during the COVID-19 pandemic. Machine learning models for classification (LDA and SVM) and regression (linear regression and SVR) were constructed to predict each symptom based on patient’s sociodemographic, clinical and contextual information. Results: A Y-BOCS score prediction model was generated with 100% reliability at a score threshold of ± 6. Reliability of 100% was reached for obsessions and/or compulsions related to COVID-19. Symptoms of anxiety and depression were predicted with less reliability (correlation R of 0.58 and 0.68, respectively). The suicidal thoughts are predicted with a sensitivity of 79% and specificity of 88%. The best results are achieved by SVM and SVR. Conclusion: Our findings reveal that sociodemographic and clinical data can be used to predict changes in OCD symptomatology. Machine learning may be valuable tool for helping clinicians to rapidly identify patients at higher risk and therefore provide optimized care, especially in future pandemics. However, further validation of these models is required to ensure greater reliability of the algorithms for clinical implementation to specific objectives of interest.Sandra Carvalho receives scholarship and support from the Portuguese Foundation for Science and Technology (FCT), co-funded through COMPETE 2020 – PO Competitividade e Internacionalização/Portugal 2020/European Union, FEDER (Fundos Europeus Estruturais e de Investimento – FEEI) under the number:PTDC/PSI-ESP/29701/2017.publishe

Obsessive compulsive disorder as a functional interhemispheric imbalance at the thalamic level

Obsessive Compulsive Disorder (OCD) involves failures in two main inhibitory processes, namely cognitive (obsessions) and behavioral (compulsions). Recent research has supported two cortical–subcortical pathways on OCD pathogenesis: (a) the frontostriatal loop (dorsolateral-caudate–striatum–thalamus) responsible for impairments of behavioral inhibition; (b) the orbitofrontal loop (orbitofrontal, medial prefrontal and cingulate) responsible for impairments with cognitive inhibitory processes. These failures in both cognitive and motor inhibitory systems may mediate several neuropsychological deficits in these patients, namely memory, attention, planning and decision making. But are those deficits related to specific hemispheric effects, namely functional imbalance between hemispheres? In this article we hypothesize that: (1) OCD patients have an inter-hemispheric functional imbalance, probably due to inadequate filtering at the thalamic level; (2) the restoration of inter-hemispheric balance, will be correlative to symptomatic improvement

MAMMALS IN PORTUGAL : A data set of terrestrial, volant, and marine mammal occurrences in P ortugal

Mammals are threatened worldwide, with 26% of all species being includedin the IUCN threatened categories. This overall pattern is primarily associatedwith habitat loss or degradation, and human persecution for terrestrial mam-mals, and pollution, open net fishing, climate change, and prey depletion formarine mammals. Mammals play a key role in maintaining ecosystems func-tionality and resilience, and therefore information on their distribution is cru-cial to delineate and support conservation actions. MAMMALS INPORTUGAL is a publicly available data set compiling unpublishedgeoreferenced occurrence records of 92 terrestrial, volant, and marine mam-mals in mainland Portugal and archipelagos of the Azores and Madeira thatincludes 105,026 data entries between 1873 and 2021 (72% of the data occur-ring in 2000 and 2021). The methods used to collect the data were: live obser-vations/captures (43%), sign surveys (35%), camera trapping (16%),bioacoustics surveys (4%) and radiotracking, and inquiries that represent lessthan 1% of the records. The data set includes 13 types of records: (1) burrowsjsoil moundsjtunnel, (2) capture, (3) colony, (4) dead animaljhairjskullsjjaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8),observation in shelters, (9) photo trappingjvideo, (10) predators dietjpelletsjpine cones/nuts, (11) scatjtrackjditch, (12) telemetry and (13) vocalizationjecholocation. The spatial uncertainty of most records ranges between 0 and100 m (76%). Rodentia (n=31,573) has the highest number of records followedby Chiroptera (n=18,857), Carnivora (n=18,594), Lagomorpha (n=17,496),Cetartiodactyla (n=11,568) and Eulipotyphla (n=7008). The data setincludes records of species classified by the IUCN as threatened(e.g.,Oryctolagus cuniculus[n=12,159],Monachus monachus[n=1,512],andLynx pardinus[n=197]). We believe that this data set may stimulate thepublication of other European countries data sets that would certainly contrib-ute to ecology and conservation-related research, and therefore assisting onthe development of more accurate and tailored conservation managementstrategies for each species. There are no copyright restrictions; please cite thisdata paper when the data are used in publications.info:eu-repo/semantics/publishedVersio

Mammals in Portugal: a data set of terrestrial, volant, and marine mammal occurrences in Portugal

Mammals are threatened worldwide, with ~26% of all species being included in the IUCN threatened categories. This overall pattern is primarily associated with habitat loss or degradation, and human persecution for terrestrial mammals, and pollution, open net fishing, climate change, and prey depletion for marine mammals. Mammals play a key role in maintaining ecosystems functionality and resilience, and therefore information on their distribution is crucial to delineate and support conservation actions. MAMMALS IN PORTUGAL is a publicly available data set compiling unpublished georeferenced occurrence records of 92 terrestrial, volant, and marine mammals in mainland Portugal and archipelagos of the Azores and Madeira that includes 105,026 data entries between 1873 and 2021 (72% of the data occurring in 2000 and 2021). The methods used to collect the data were: live observations/captures (43%), sign surveys (35%), camera trapping (16%), bioacoustics surveys (4%) and radiotracking, and inquiries that represent less than 1% of the records. The data set includes 13 types of records: (1) burrows | soil mounds | tunnel, (2) capture, (3) colony, (4) dead animal | hair | skulls | jaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8), observation in shelters, (9) photo trapping | video, (10) predators diet | pellets | pine cones/nuts, (11) scat | track | ditch, (12) telemetry and (13) vocalization | echolocation. The spatial uncertainty of most records ranges between 0 and 100 m (76%). Rodentia (n =31,573) has the highest number of records followed by Chiroptera (n = 18,857), Carnivora (n = 18,594), Lagomorpha (n = 17,496), Cetartiodactyla (n = 11,568) and Eulipotyphla (n = 7008). The data set includes records of species classified by the IUCN as threatened (e.g., Oryctolagus cuniculus [n = 12,159], Monachus monachus [n = 1,512], and Lynx pardinus [n = 197]). We believe that this data set may stimulate the publication of other European countries data sets that would certainly contribute to ecology and conservation-related research, and therefore assisting on the development of more accurate and tailored conservation management strategies for each species. There are no copyright restrictions; please cite this data paper when the data are used in publications

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Infección peritoneal postoperatoria y recurrencia del cáncer colorrectal: Estudio de las respuestas inflamatoria y angiogénica como mecanismos responsables de esta asociación

Introducción: La infección peritoneal postoperatoria se asocia con una mayor recurrencia y menor supervivencia en pacientes intervenidos de cáncer colorrectal. Los mecanismos responsables de esta asociación no son conocidos. La hipótesis del presente estudio es que los pacientes intervenidos de cáncer colorrectal que presentan una infección peritoneal en el postoperatorio desarrollan una mayor respuesta inflamatoria y angiogénica en comparación con aquellos pacientes que tienen un curso postoperatorio sin complicaciones. Esta amplificación de la inflamación y de la angiogénesis podría explicar el mayor porcentaje de recurrencia tumoral observado en estos pacientes. Material y métodos: Es un estudio de cohortes con controles apareados. El grupo infección está formado por pacientes con infección peritoneal postoperatoria (dehiscencia anastomótica y abscesos). El grupo control ha sido seleccionado entre los pacientes sin complicaciones, apareados según sexo, edad, procedimiento y estadio tumoral. Se han obtenido muestras de suero y líquido peritoneal basales, 48 horas y 4º día del postoperatorio para la determinación de interleuquina-6 (IL-6) y factor de crecimiento del endotelio vascular (VEGF). Con el fin de poder identificar otros mediadores implicados en la respuesta inflamatoria y angiogénica se procedió a realizar un análisis comparativo de la expresión diferencial de genes mediante un estudio de microarrays de DNA. Se realizó la extracción de ARN total a partir de sangre total según el método Leucolock®. El análisis posterior de microarray de expresión se utilizó el GeneChip Human Gene 1.0 ST, de Affymetrix. Resultados: No hubo diferencias en las características demográficas e histopatológicas entre el grupo infección (n=30) y el grupo control (n=30). La concentración de IL-6 en el 4º día en suero fue mayor en el grupo infección (grupo control: 29 ± 93 vs. grupo infección: 1608 ± 3336 pg/ml, p=0,008) mientras que en el líquido peritoneal fue mayor tanto a las 48h (grupo control: 350 ± 403 vs. grupo infección: 1318 ± 561 pg/ml; p=0,001) como al 4º día (grupo control: 228 ± 415 vs. grupo infección: 1152 ± 470 pg/ml; p=0,001). La concentración de VEGF en suero también fue mayor en el grupo infección al 4º día (grupo control: 458 ± 312 vs. grupo infección: 3329 ± 4103 pg/ml; p=0,001) y en líquido peritoneal a las 48h (grupo control: 556 ± 384 vs. grupo infección: 5859 ± 4445 pg/ml; p=0,001) y al 4º día (grupo control: 674 ±941 vs. grupo infección: 7048 ± 4092 pg/ml; p=0,001). El análisis de microarray mostró nueve genes sobreexpresados en el grupo de infección (CD177, NECAB1, OLFM4, MMP8, HP, TDRD9, GPR84 y ARG1) implicados en inflamación,angiogénesis y proliferación tumoral. La recurrencia acumulada a los 3 años fue significativamente mayor en el grupo infección (43% vs. 13%; log rank test p=0,001). En el análisis multivariado obtuvimos como factores de riesgo independiente para la recurrencia la infección peritoneal ( RR=8,443 IC 95%= 2,019-35,309 p=0,003), la invasión neural ( RR=3,910 IC 95%= 1,344-11,379 p=0,012) y la afectación ganglionar( RR=5,851 IC 95%= 1,851-18,490 p=0,003). Conclusión: La infección peritoneal postoperatoria induce una amplificación de la respuesta inflamatoria y angiogénica en pacientes intervenidos de cáncer colorrectal con intención curativa. Estos cambios pueden explicar el mayor porcentaje de recurrencia tumoral observado en estos pacientes.Introduction: Postoperative peritoneal infection is associated with increased recurrence and decreased survival in patients undergoing surgery for colorectal cancer. The mechanisms responsible for this association are not known. The hypothesis of this study is that patients undergoing colorectal cancer who have a postoperative peritoneal infection have an increased inflammatory and angiogenic response compared to those patients who have an uncomplicated postoperative course. This amplification of inflammation and angiogenesis may explain the higher percentage of tumor recurrence observed in these patients. Material and methods: A cohort study with matched controls. The infection group consisted of patients with postoperative peritoneal infection (abscesses and anastomotic dehiscence). The control group was selected from patients without complications, matched by sex, age, surgical technique and tumor stage. Were obtained serum and peritoneal fluid baseline, 48 hours and postoperative day 4 for determination of interleukin-6 (IL-6) and endothelial growth factor (VEGF). In order to identify other mediators involved in inflammatory and angiogenic response proceeded to perform a comparative analysis of differential gene expression using a DNA microarray study. Extraction was performed with total RNA from whole blood using the method Leucolock ®. Subsequent analysis of microarray expression was used GeneChip Human Gene 1.0 ST, Affymetrix. Results: There were no differences in demographic characteristics and histopathological between infection group (n = 30) and control group (n = 30). The concentration of IL-6 at day 4 in serum was higher in the infection group (control group: 29 ± 93 vs. Group infection: 1608 ± 3336 pg / ml, p = 0.008) while in the peritoneal fluid was higher both at 48h (control group: 350 ± 403 vs. group infection: 1318 ± 561 pg / ml, p = 0.001) and at day 4 (control group: 228 ± 415 vs. group infection: 1152 ± 470 pg / ml, P = 0.001). The concentration of VEGF in serum was also higher in the infection by day 4 (control group: 458 ± 312 vs. Group infection: 3329 ± 4103 pg / ml, p = 0.001) and peritoneal fluid at 48h (control group: 556 ± 384 vs. infection group: 5859 ± 4445 pg / ml, p = 0.001) and at day 4 (control group: 674 ± 941 vs. infection group: 7048 ± 4092 pg / ml, p = 0.001). The microarray analysis showed nine genes overexpressed in the infection group (CD177, NECAB1, OLFM4, MMP8, HP, TDRD9, GPR84 and ARG1) involved in inflammation, angiogenesisand tumor proliferation. The cumulative recurrence at 3 years was significantly higher in the infection group (43% vs. 13%, log rank test p = 0.001). In multivariate analysis we obtained as independent risk factors for tumor recurrence: peritoneal infection (RR = 8.443 95% CI = 2.019 to 35.309 p = 0.003), neural invasion (RR = 3.910 95% CI = 1.344 to 11.379 p = 0.012) and lymph node involvement (RR = 5.851 95% CI = 1.851 to 18.490 p = 0.003). Conclusion: The postoperative peritoneal infection induces an amplification of the inflammatory and angiogenic response in colorectal cancer patients treated with curative intent. These changes may explain the higher rate of tumor recurrence observed in these patients

Infección peritoneal postoperatoria y recurrencia del cáncer colorrectal : estudio de las respuestas inflamatoria y angiogénica como mecanismos responsables de esta asociación /

Descripció del recurs: 9 juliol 2013Introducción: La infección peritoneal postoperatoria se asocia con una mayor recurrencia y menor supervivencia en pacientes intervenidos de cáncer colorrectal. Los mecanismos responsables de esta asociación no son conocidos. La hipótesis del presente estudio es que los pacientes intervenidos de cáncer colorrectal que presentan una infección peritoneal en el postoperatorio desarrollan una mayor respuesta inflamatoria y angiogénica en comparación con aquellos pacientes que tienen un curso postoperatorio sin complicaciones. Esta amplificación de la inflamación y de la angiogénesis podría explicar el mayor porcentaje de recurrencia tumoral observado en estos pacientes. Material y métodos: Es un estudio de cohortes con controles apareados. El grupo infección está formado por pacientes con infección peritoneal postoperatoria (dehiscencia anastomótica y abscesos). El grupo control ha sido seleccionado entre los pacientes sin complicaciones, apareados según sexo, edad, procedimiento y estadio tumoral. Se han obtenido muestras de suero y líquido peritoneal basales, 48 horas y 4º día del postoperatorio para la determinación de interleuquina-6 (IL-6) y factor de crecimiento del endotelio vascular (VEGF). Con el fin de poder identificar otros mediadores implicados en la respuesta inflamatoria y angiogénica se procedió a realizar un análisis comparativo de la expresión diferencial de genes mediante un estudio de microarrays de DNA. Se realizó la extracción de ARN total a partir de sangre total según el método Leucolock®. El análisis posterior de microarray de expresión se utilizó el GeneChip Human Gene 1.0 ST, de Affymetrix. Resultados: No hubo diferencias en las características demográficas e histopatológicas entre el grupo infección (n=30) y el grupo control (n=30). La concentración de IL-6 en el 4º día en suero fue mayor en el grupo infección (grupo control: 29 ± 93 vs. grupo infección: 1608 ± 3336 pg/ml, p=0,008) mientras que en el líquido peritoneal fue mayor tanto a las 48h (grupo control: 350 ± 403 vs. grupo infección: 1318 ± 561 pg/ml; p=0,001) como al 4º día (grupo control: 228 ± 415 vs. grupo infección: 1152 ± 470 pg/ml; p=0,001). La concentración de VEGF en suero también fue mayor en el grupo infección al 4º día (grupo control: 458 ± 312 vs. grupo infección: 3329 ± 4103 pg/ml; p=0,001) y en líquido peritoneal a las 48h (grupo control: 556 ± 384 vs. grupo infección: 5859 ± 4445 pg/ml; p=0,001) y al 4º día (grupo control: 674 ±941 vs. grupo infección: 7048 ± 4092 pg/ml; p=0,001). El análisis de microarray mostró nueve genes sobreexpresados en el grupo de infección (CD177, NECAB1, OLFM4, MMP8, HP, TDRD9, GPR84 y ARG1) implicados en inflamación,angiogénesis y proliferación tumoral. La recurrencia acumulada a los 3 años fue significativamente mayor en el grupo infección (43% vs. 13%; log rank test p=0,001). En el análisis multivariado obtuvimos como factores de riesgo independiente para la recurrencia la infección peritoneal ( RR=8,443 IC 95%= 2,019-35,309 p=0,003), la invasión neural ( RR=3,910 IC 95%= 1,344-11,379 p=0,012) y la afectación ganglionar( RR=5,851 IC 95%= 1,851-18,490 p=0,003). Conclusión: La infección peritoneal postoperatoria induce una amplificación de la respuesta inflamatoria y angiogénica en pacientes intervenidos de cáncer colorrectal con intención curativa. Estos cambios pueden explicar el mayor porcentaje de recurrencia tumoral observado en estos pacientes.Introduction: Postoperative peritoneal infection is associated with increased recurrence and decreased survival in patients undergoing surgery for colorectal cancer. The mechanisms responsible for this association are not known. The hypothesis of this study is that patients undergoing colorectal cancer who have a postoperative peritoneal infection have an increased inflammatory and angiogenic response compared to those patients who have an uncomplicated postoperative course. This amplification of inflammation and angiogenesis may explain the higher percentage of tumor recurrence observed in these patients. Material and methods: A cohort study with matched controls. The infection group consisted of patients with postoperative peritoneal infection (abscesses and anastomotic dehiscence). The control group was selected from patients without complications, matched by sex, age, surgical technique and tumor stage. Were obtained serum and peritoneal fluid baseline, 48 hours and postoperative day 4 for determination of interleukin-6 (IL-6) and endothelial growth factor (VEGF). In order to identify other mediators involved in inflammatory and angiogenic response proceeded to perform a comparative analysis of differential gene expression using a DNA microarray study. Extraction was performed with total RNA from whole blood using the method Leucolock ®. Subsequent analysis of microarray expression was used GeneChip Human Gene 1.0 ST, Affymetrix. Results: There were no differences in demographic characteristics and histopathological between infection group (n = 30) and control group (n = 30). The concentration of IL-6 at day 4 in serum was higher in the infection group (control group: 29 ± 93 vs. Group infection: 1608 ± 3336 pg / ml, p = 0.008) while in the peritoneal fluid was higher both at 48h (control group: 350 ± 403 vs. group infection: 1318 ± 561 pg / ml, p = 0.001) and at day 4 (control group: 228 ± 415 vs. group infection: 1152 ± 470 pg / ml, P = 0.001). The concentration of VEGF in serum was also higher in the infection by day 4 (control group: 458 ± 312 vs. Group infection: 3329 ± 4103 pg / ml, p = 0.001) and peritoneal fluid at 48h (control group: 556 ± 384 vs. infection group: 5859 ± 4445 pg / ml, p = 0.001) and at day 4 (control group: 674 ± 941 vs. infection group: 7048 ± 4092 pg / ml, p = 0.001). The microarray analysis showed nine genes overexpressed in the infection group (CD177, NECAB1, OLFM4, MMP8, HP, TDRD9, GPR84 and ARG1) involved in inflammation, angiogenesisand tumor proliferation. The cumulative recurrence at 3 years was significantly higher in the infection group (43% vs. 13%, log rank test p = 0.001). In multivariate analysis we obtained as independent risk factors for tumor recurrence: peritoneal infection (RR = 8.443 95% CI = 2.019 to 35.309 p = 0.003), neural invasion (RR = 3.910 95% CI = 1.344 to 11.379 p = 0.012) and lymph node involvement (RR = 5.851 95% CI = 1.851 to 18.490 p = 0.003). Conclusion: The postoperative peritoneal infection induces an amplification of the inflammatory and angiogenic response in colorectal cancer patients treated with curative intent. These changes may explain the higher rate of tumor recurrence observed in these patients

El tatuaje endoscópico en las neoplasias colorrectales intervenidas vía laparoscópica: una propuesta de marcaje selectivo

RESUMEN Introducción y objetivo: el tatuaje endoscópico preoperatorio es un procedimiento eficaz que permite la localización intraoperatoria de neoplasias de pequeño tamaño. Sin embargo, actualmente no existen unos criterios definidos sobre las indicaciones del tatuaje endoscópico de estas neoplasias en el momento del diagnóstico. El objetivo es establecer unos criterios endoscópicos para seleccionar los pacientes que precisarán un tatuaje. Material y métodos: estudio ambispectivo de pacientes intervenidos de neoplasia colorrectal por laparoscopia en los que se realizó tatuaje endoscópico en el periodo (2007-2013 y 2016-2017). De acuerdo con la descripción endoscópica de las neoplasias se clasificaron en: lesiones polipoideas, neoplasias que ocupan < 50% o ≥ 50% de la luz intestinal y neoplasias estenosantes. Resultados: se realizó tatuaje de la lesión en 120 pacientes y en 114 (95%) se identificó el mismo durante la cirugía. La mayor parte de las neoplasias descritas como polipoideas y neoplasias que ocupaban < 50% de la luz intestinal no se visualizaban en la cirugía y por tanto precisaban el tatuaje (33 de 42 y 18 de 26 respectivamente, p = 0.0001, 2). En cambio, aquellas lesiones estenosantes o bien neoplasias que ocupaban ≥ 50% de la luz intestinal se identificaban mayoritariamente en la cirugía (15 de 15 y 36 de 37 respectivamente, p = 0.0001, 2) sin necesidad de tatuaje. En conjunto la identificación de las neoplasias según los criterios establecidos fue del 98%. Conclusiones: estos resultados sugieren que es posible establecer unos criterios endoscópicos que permitan realizar un tatuaje selectivo durante la endoscopia diagnóstica manteniendo el éxito del mismo

Effects of nickel hyperaccumulation in Alyssum pintodasilvae on model arthropods representatives of two trophic levels

Abstract An experimental assessment of the defence hypothesis of nickel (Ni) hyperaccumulation in Alyssum was lacking. Also, to date no study had investigated the effects of hyperaccumulator litter on a detritivore species. We performed several experiments with model arthropods representatives of two trophic levels: Tribolium castaneum (herbivore) and Porcellio dilatatus (detritivore). In no-choice trials using artificial food disks with different Ni concentrations, T. castaneum fed significantly less as Ni concentration increased and totally rejected disks with the highest Ni concentration. In choice tests, insects preferred disks without Ni. In the no-choice experiment, mortality was low and did not differ significantly among treatments. Hence, this suggested a deterrent effect of high Ni diet. Experiments with P. dilatatus showed that isopods fed A. pintodasilvae litter showed significantly greater mortality (83%) than isopods fed litter from the non-hyperaccumulator species Iberis procumbens (8%), Micromeria juliana (no mortality) or Alnus glutinosa (no mortality). Also, isopods consumed significantly greater amounts of litter from the non-hyperaccumulator plant species. The behaviour of isopods fed A. pintodasilvae litter suggested an antifeedant effect of Ni, possibly due to post-ingestive toxic effects. Our results support the view that Ni defends the Portuguese serpentine hyperaccumulator A. pintodasilvae against herbivores, indicating that Ni can account both for feeding deterrence and toxic effects. The effects of hyperaccumulator litter on the detritivore P. dilatatus suggest that the activity of these important organisms may be significantly impaired with potential consequences on the decomposition processes