Small intestinal bacterial overgrowth in irritable bowel syndrome: are there any predictors?

<p>Abstract</p> <p>Background</p> <p>Small intestinal bacterial overgrowth (SIBO) is a condition in which excessive levels of bacteria, mainly the colonic-type species are present in the small intestine. Recent data suggest that SIBO may contribute to the pathophysiology of Irritable bowel syndrome (IBS). The purpose of this study was to identify potential predictors of SIBO in patients with IBS.</p> <p>Methods</p> <p>Adults with IBS based on Rome II criteria who had predominance of bloating and flatulence underwent a glucose breath test (GBT) to determine the presence of SIBO. Breath samples were obtained at baseline and at 30, 45, 60, 75 and 90 minutes after ingestion of 50 g of glucose dissolved in 150 mL of water. Results of the glucose breath test, which measures hydrogen and methane levels in the breath, were considered positive for SIBO if 1) the hydrogen or methane peak was >20 ppm when the baseline was <10 ppm, or 2) the hydrogen or methane peak increased by 12 ppm when baseline was ≥10 ppm.</p> <p>Results</p> <p>Ninety-eight patients were identified who underwent a GBT (mean age, 49 y; 78% female). Thirty-five patients (36%) had a positive GBT result suggestive of SIBO. A positive GBT result was more likely in patients >55 years of age (odds ratio [OR], 3.6; 95% confidence interval [CI], 1.4-9.0) and in females (OR, 4.0; 95% CI, 1.1-14.5). Hydrogen was detected more frequently in patients with diarrhea-predominant IBS (OR, 8; 95% CI, 1.4-45), and methane was the main gas detected in patients with constipation-predominant IBS (OR, 8; 95% CI, 1.3-44). There was no significant correlation between the presence of SIBO and the predominant bowel pattern or concurrent use of tegaserod, proton pump inhibitors, or opiate analgesics.</p> <p>Conclusions</p> <p>Small intestinal bacterial overgrowth was present in a sizeable percentage of patients with IBS with predominance of bloating and flatulence. Older age and female sex were predictors of SIBO in patients with IBS. Identification of possible predictors of SIBO in patients with IBS could aid in the development of successful treatment plans.</p

The paradigm of norgestimate: a third-generation testosterone-derivative progestin with a peripheral anti-androgenic activity and the lowest risk of venous thromboembolism

Introduction: Norgestimate (NGM) is a testosterone derivative with peculiar receptor activities. Areas covered: This is a narrative review of the available data on the pharmacotherapy of NGM in combined hormonal contraceptives (CHCs) in terms of contraceptive efficacy, venous thromboembolism (VTE) risk, safety, tolerability and bleeding patterns. A comprehensive literature review was conducted in August 2020 using PubMed with the keyword ‘norgestimate’. Expert Opinion: NGM shows a mild estrogenic activity associated with anti-mineralocorticoid and anti-androgenic properties, largely responsible for the cardiovascular safety profile. The anti-androgenic property depends on the androgen receptor (AR) nuclear translocation (AR trafficking and its subnuclear distribution), the inhibition of 5α-reductase activity (it possesses higher activity compared to other available progestins), and the increase on sexual hormone binding globulin (SHBG) levels if combined with an estrogenic counterpart. NGM is one of the molecules that best modulates the power of ethinyl-estradiol on the thromboembolic risk, being associated with the lowest VTE risk between different CHCs. NGM has the advantage of retaining peripheral anti-androgenic activity, demonstrated by the impact on lipid and glucose metabolism, and it should be preferred if compared with other similar progestins of the same class of risk which are much more androgenic, such as levonorgestrel

A lower bound for interval routing in general networks

Includes bibliographical references (p. 11).At head of title: Computer science publication.Cover title.published_or_final_versio

Gastroparesis secondary to a demyelinating disease: a case series

BACKGROUND: Gastroparesis has a number of etiologies. The main ones are secondary to a complication from diabetes mellitus, related to post vagotomy or post gastric surgical resections, or idiopathic when the etiology is unclear. Gastroparesis secondary to a demyelinating disease of the brain is unusual. CASE PRESENTATION: A 22-year-old woman was referred for acute onset of intractable nausea and vomiting. She also had cerebellar deficits, dysphagia and paresthesias. Magnetic resonance imaging (MRI) of the brain revealed an isolated area of demyelination in the medullary region. Another 24-year-old woman had a similar presentation with right hemiplegia and MRI of the brain revealed a distal medullary region. Both these patients had an abnormal gastric emptying test. Gastroparesis and neurological deficits improved with intravenous corticosteroids. While the former patient has had no further recurrences, the latter patient developed multiple sclerosis within three months of presentation. CONCLUSION: A demyelinating disease is a rare cause gastropareis, but should be suspected when symptoms of gastroparesis are associated with neurological deficits. MRI might help in the diagnosis and intravenous coriticosteroids can address the underlying disease process and improve gastric emptying, especially when used early during the course of the disease

comparison between thermal energy and acoustic emission for the fatigue behavior of steels

Abstract The paper is focused on the study of fatigue materials, using an energy approach, with the support of two different non-destructive techniques. Indeed, the analysis of the energy behavior was conducted by the simultaneous application of Acoustic Emission (AE) and Thermography (TH). The purpose of the paper was to compare and integrate the results obtained by the two methodologies to assess the fatigue behavior of materials. The experimental tests were carried out on flat steel specimens of steels commonly used for metal carpentry either under static loading or under sequences of increasing cyclic loading. The results allow to define the fatigue limit either by the thermography or by the acoustic emission and they are encouraging to continue the comparison and the integration between the two energetic methodologies

Nanoscale magnetic field mapping with a single spin scanning probe magnetometer

We demonstrate quantitative magnetic field mapping with nanoscale resolution, by applying a lock-in technique on the electron spin resonance frequency of a single nitrogen-vacancy defect placed at the apex of an atomic force microscope tip. In addition, we report an all-optical magnetic imaging technique which is sensitive to large off-axis magnetic fields, thus extending the operation range of diamond-based magnetometry. Both techniques are illustrated by using a magnetic hard disk as a test sample. Owing to the non-perturbing and quantitative nature of the magnetic probe, this work should open up numerous perspectives in nanomagnetism and spintronics

Postpartum contraception: A matter of guidelines

: The postpartum period is the perfect time to access family planning services. WHO guidelines contraindicate combined hormonal contraceptives postpartum in breastfeeding patients between 6 weeks and 6 months after delivery (Medical Eligibility Criteria category 3). On the contrary, the Faculty of Sexual and Reproductive Healthcare and the Centers for Disease Control and Prevention guidelines do not contraindicate their use in women who breastfeed from 6 weeks to 6 months postpartum. New combined hormonal contraceptives with natural estrogens have never been studied in this setting. Guidelines agree on the prescription of the progestin-only pill postpartum in non-breastfeeding women (category 1). Differences are found in women who breastfeed. In non-breastfeeding women, an implant is considered safe (category 1) by all guidelines, without any distinction in time. Regarding postpartum breastfeeding women, the guidelines for implants give quite different indications but are still permissive. Intrauterine devices are viable options for postpartum contraception but guidelines give different indications about the timing of insertion. Postplacental intrauterine device placement can reduce the subsequent unintended pregnancy rate, particularly in settings at greatest risk of not having recommended postpartum controls. However, it has yet to be understood whether this approach can really have an advantage in high-income countries. Postpartum contraception is not a 'matter of guidelines': it is the best customization for each woman, as early as possible but at the ideal timing

Keeping track of phaeodactylum tricornutum (Bacillariophyta) culture contamination by potentiometric e-tongue

The large-scale cultivation of microalgae provides a wide spectrum of marketable bioproducts, profitably used in many fields, from the preparation of functional health products and feed supplement in aquaculture and animal husbandry to biofuels and green chemistry agents. The commercially successful algal biomass production requires effective strategies to maintain the process at desired productivity and stability levels. Hence, the development of effective early warning methods to timely indicate remedial actions and to undertake countermeasures is extremely important to avoid culture collapse and consequent economic losses. With the aim to develop an early warning method of algal contamination, the potentiometric E-tongue was applied to record the variations in the culture environments, over the whole growth process, of two unialgal cultures, Phaeodactylum tricornutum and a microalgal contaminant, along with those of their mixed culture. The E-tongue system ability to distinguish the cultures and to predict their growth stage, through the application of multivariate data analysis, was shown. A PLS regression method applied to the E-tongue output data allowed a good prediction of culture growth time, expressed as growth days, with R-2 values in a range from 0.913 to 0.960 and RMSEP of 1.97-2.38 days. Moreover, the SIMCA and PLS-DA techniques were useful for cultures contamination monitoring. The constructed PLS-DA model properly discriminated 67% of cultures through the analysis of their growth media, i.e., environments, thus proving the potential of the E-tongue system for a real time monitoring of contamination in microalgal intensive cultivation

Boschi vetusti e riserve forestali nel Veneto: patrimoni di biodiversita\u300

Vengono sintetizzate le criticita\u300 emergenti legate alle dinamiche di cambiamento della biodiversita\u300 nelle foreste del Veneto anche esaminando i dati delle politiche forestali degli ultimi decenni e delle trasformazioni di boschi e foreste di montagna, collina e pianura conseguenti all\u2019abbandono colturale e ad iniziative locali di contrasto alle alterazioni del paesaggio forestale, di miglioramento ambientale ed estetico e di difesa della biodiversita\u300 forestale e naturalistica dei territori del Veneto. Seppur in un confronto europeo l'Italia e\u300 forse uno degli stati piu\u300 virtuosi nella gestione del patrimonio boschivo, sia in termini di risparmio di biomassa (35% di prelievo sull'incremento contro la media europea di oltre 60%) che per modalita\u300 di prelievo (e\u300 uno dei pochi stati dove il taglio a raso e\u300 vietato e, a differenza di molti paesi europei, non ammette l'imboschimento con specie esotiche), in questo approfondimento vengono esaminati gli scenari possibili di riferimento per una programmazione piu\u300 mirata, incisiva ed innovativa delle politiche di tutela della biodiversita\u300 forestale del Veneto, guardando ad alcune esperienze europee volte alla tutela e valorizzazione dei boschi antichi o vetusti. Boschi e foreste si stanno espandendo nel Veneto anche in pianura: ma questo trend e\u300 frutto dell\u2019abbandono colturale e/o conseguenza di una programmazione territoriale adeguata? Si propongono linee guida per iniziative locali di contrasto alla banalizzazione estetica ed ambientale del paesaggio e per contro di miglioramento della difesa della biodiversita\u300 forestale e naturalistica dei territori del Veneto partendo dalla tutela del patrimonio genetico dei \u201cboschi vetusti\u201d