Diagnostic efficacy of push-enteroscopy and long-term follow-up of patients with small bowel angiodysplasias

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Influence of cladding panels on the first period of one-story precast buildings

During the recent severe seismic events, as L’Aquila (2009) and Emilia earthquakes (2012), the collapse of cladding panels system in precast buildings has been frequently observed due to their connection system failure. Such a damage have demonstrated the deficiency of the actual design approach, that considers cladding panels as non-structural elements, neglecting any interaction with the structure under bi-directional and dynamic seismic excitations. This paper investigates the influence of vertical cladding panels on the first vibration period of one-story precast concrete buildings, with floor rigid in its own plane. At this purpose, a bare structural elastic model and an innovative elastic model of the building with cladding system are implemented and a parametric study is performed. The results of the parametric study show a high influence of the panels on the first period of the analyzed buildings, as well as the inadequacy for this typology of buildings of the simplified relationship for computing the fundamental period proposed by some codes. More suitable formulas are proposed to evaluate the first period in a linear static analysis of one-story precast buildings, both in the case of bare buildings and of buildings with cladding system

Is the Distal Hyperplastic Polyp a Marker for Proximal Neoplasia?: A Systematic Review

CONTEXT: The current literature is unclear about the association between distal hyperplastic polyps and synchronous neoplasia (adenomatous polyps and cancer) in the proximal colon. OBJECTIVE: To estimate the prevalence of proximal neoplasia associated with distal hyperplastic polyps. DATA SOURCES: Database searches (medline and embase from 1966 to 2001) and manual search of the bibliographies of included and excluded studies, case reports, editorials, review articles, and textbooks of Gastroenterology. STUDY SELECTION: Studies describing the prevalence of proximal neoplasia in persons with distal hyperplastic polyps. DATA EXTRACTION: Demographics, clinical variables, study design, and prevalence of proximal neoplasia associated with various distal colorectal findings. DATA SYNTHESIS: Of 18 included studies, 12 involved asymptomatic individuals in which the pooled absolute risk of any proximal neoplasia associated with distal hyperplastic polyps was 25% (95% confidence interval [95% CI], 21% to 29%). In 4 studies where colonoscopy was performed irrespective of distal findings, the absolute risk was 21% (95% CI, 14% to 28%). The relative risk of finding any proximal neoplasia in persons with distal hyperplastic polyps was 1.3 (95% CI, 0.9 to 1.8) compared to those with no distal polyps. Among 6 studies of patients with symptoms or risk factors for neoplasia, the absolute risk of proximal neoplasia was 35% (95% CI, 32% to 39%) in persons with distal hyperplastic polyps. In 2 studies of screening colonoscopy, advanced proximal neoplasia (cancer, or a polyp with villous histology or severe dysplasia, or a tubular adenoma ≥1 cm) was present in 4% to 5% of persons with distal hyperplastic polyps, which was 1.5 to 2.6 times greater than in those with no distal polyps. CONCLUSIONS: In asymptomatic persons, a distal hyperplastic polyp is associated with a 21% to 25% risk for any proximal neoplasia and a 4% to 5% risk of advanced proximal neoplasia, and may justify examination of the proximal colon. Further study is needed to determine the risk of advanced proximal neoplasia associated with size and number of distal hyperplastic polyps