Red hot chili pepper and hemorrhoids: The explosion of a myth: Results of a prospective, randomized, placebo-controlled, crossover trial

PURPOSE: Spicy foods are appreciated by a large part of the world population but have been blamed for causing hemorrhoids or exacerbating their symptoms, although no epidemiologic studies have been performed supporting this hypothesis. In this double-blind, randomized, placebo-controlled, crossover trial, we have studied the effects of a single dose of red hot chili pepper on the hemorrhoidal symptoms. METHODS: Fifty patients with second-degree and third-degree symptomatic hemorrhoids were randomly assigned to take a capsule containing red hot chili powder or placebo during lunch, scoring five hemorrhoidal symptoms (bleeding, swelling, pain, itching, and burning) on a visual analog scale. After one week, crossover treatment was administered according to the same methodology. Other treatments and foods potentially related with anorectal symptoms were discontinued during the study periods. RESULTS: Patients assigned low scores to their hemorrhoidal symptoms before the study and the scores remained unchanged during the 48 hours after both placebo and chili pepper treatment, the latter showing no statistically significant effects. CONCLUSIONS: There is no scientific evidence that a spicy meal based on red hot chili pepper may worsen hemorrhoidal symptoms and, therefore, there is no reason to prevent these patients from occasionally enjoying a spicy dish if they so wish

Acute Delta Hepatitis in Italy spanning three decades (1991–2019): Evidence for the effectiveness of the hepatitis B vaccination campaign

Updated incidence data of acute Delta virus hepatitis (HDV) are lacking worldwide. Our aim was to evaluate incidence of and risk factors for acute HDV in Italy after the introduction of the compulsory vaccination against hepatitis B virus (HBV) in 1991. Data were obtained from the National Surveillance System of acute viral hepatitis (SEIEVA). Independent predictors of HDV were assessed by logistic-regression analysis. The incidence of acute HDV per 1-million population declined from 3.2 cases in 1987 to 0.04 in 2019, parallel to that of acute HBV per 100,000 from 10.0 to 0.39 cases during the same period. The median age of cases increased from 27 years in the decade 1991-1999 to 44 years in the decade 2010-2019 (p < .001). Over the same period, the male/female ratio decreased from 3.8 to 2.1, the proportion of coinfections increased from 55% to 75% (p = .003) and that of HBsAg positive acute hepatitis tested for by IgM anti-HDV linearly decreased from 50.1% to 34.1% (p < .001). People born abroad accounted for 24.6% of cases in 2004-2010 and 32.1% in 2011-2019. In the period 2010-2019, risky sexual behaviour (O.R. 4.2; 95%CI: 1.4-12.8) was the sole independent predictor of acute HDV; conversely intravenous drug use was no longer associated (O.R. 1.25; 95%CI: 0.15-10.22) with this. In conclusion, HBV vaccination was an effective measure to control acute HDV. Intravenous drug use is no longer an efficient mode of HDV spread. Testing for IgM-anti HDV is a grey area requiring alert. Acute HDV in foreigners should be monitored in the years to come

Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes

Background: Albuminuria has been classically considered a marker of kidney damage progression in diabetic patients and it is routinely assessed to monitor kidney function. However, the role of a mild GFR reduction on the development of stage 653 CKD has been less explored in type 1 diabetes mellitus (T1DM) patients. Aim of the present study was to evaluate the prognostic role of kidney disease measures, namely albuminuria and reduced GFR, on the development of stage 653 CKD in a large cohort of patients affected by T1DM. Methods: A total of 4284 patients affected by T1DM followed-up at 76 diabetes centers participating to the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD) initiative constitutes the study population. Urinary albumin excretion (ACR) and estimated GFR (eGFR) were retrieved and analyzed. The incidence of stage 653 CKD (eGFR < 60 mL/min/1.73 m2) or eGFR reduction > 30% from baseline was evaluated. Results: The mean estimated GFR was 98 \ub1 17 mL/min/1.73m2 and the proportion of patients with albuminuria was 15.3% (n = 654) at baseline. About 8% (n = 337) of patients developed one of the two renal endpoints during the 4-year follow-up period. Age, albuminuria (micro or macro) and baseline eGFR < 90 ml/min/m2 were independent risk factors for stage 653 CKD and renal function worsening. When compared to patients with eGFR > 90 ml/min/1.73m2 and normoalbuminuria, those with albuminuria at baseline had a 1.69 greater risk of reaching stage 3 CKD, while patients with mild eGFR reduction (i.e. eGFR between 90 and 60 mL/min/1.73 m2) show a 3.81 greater risk that rose to 8.24 for those patients with albuminuria and mild eGFR reduction at baseline. Conclusions: Albuminuria and eGFR reduction represent independent risk factors for incident stage 653 CKD in T1DM patients. The simultaneous occurrence of reduced eGFR and albuminuria have a synergistic effect on renal function worsening

Complexity and Flexible Grid Networks

For the optimization of routing and spectrum allocation in a FlexiGrid Networks, we explore the tradeoff between network cost and problem complexity according to the following aspects: traffic grooming, regeneration, modulation/baud-rate assignment

Rapid and reliable identification of Staphylococcus aureus harbouring the enterotoxin gene cluster (egc) and quantitative detection in raw milk by real time PCR

A TaqMan and a SYBR Green real time PCR (rt-PCR) were developed for the reliable identi␣cation and quantitative detection of Staphylococcus (S.) aureus strains harbouring the enterotoxin gene cluster (egc) regardless of its variants. Both approaches revealed 100% speci␣city against a panel of 70 reference strains, including 29 clinical and foodborne S. aureus strains harbouring all the egc variants to date known, 4 egc␣ S. aureus strains and 37 strains of phylogenetically closely and distantly related species. Standard curves made by 10 fold dilutions of either genomic DNA or cells from an egc+ S. aureus log-phase broth culture showed a good linearity of response (R2 0.993) for six orders of magnitude, with about 100% relative accuracy and a low inter-assay variability (CV à 3.02). The overall limit of quanti␣cation (LOQ) for both rt-PCR assays (about 100% PCR ef␣ciency; running time 30 min) was 10 cfu or 10 genome equivalents per reaction mixture although 1 cfu or 1 genome equivalent was detected with a 33.33% probability. These performances were con␣rmed in raw milk arti␣cially contaminated with log-phase broth cultures of either a single egc+ S. aureus strain or a mixture of S. aureus strains harbouring all the egc variants to date known. Similar results were also obtained with a raw milk based standard curve of the S. aureus egc+ mixture in the presence of 106 cfu/mL of egc␣ S. aureus strains harbouring some of the commonest enterotoxin genes associated to the staphylococcal food poisoning. Nonetheless, the TaqMan based approach resulted in a lower sensitivity (LOQ=100cfu equivalents per reaction mixture) than the SYBR Green based assay (LOQ = 10 cfu equivalents per reaction mixture). When applied to real milk samples, both PCR assays provided a good response with 100% diagnostic speci␣city and 96–107% relative accuracy, as compared to conventional culture-based PCR approaches. Due to the high speci␣city, the wide dynamic range of detection and the high sensitivity demonstrated even in a complex and potentially highly contaminated raw milk matrix, the SYBR Green rt-PCR assay is a useful diagnostic tool for quick, high throughput and reliable routine screening of egc+ S. aureus isolates. Moreover, the SYBR Green based quantitative detection of these pathogens in raw milk could remarkably contribute to clarify their actual role in staphylococcal food poisoning and other clinical syndromes associated with the consumption of milk and milk-based products

On the Complexity of Routing and Spectrum Assignment in Flexible Grid Ring Networks

The adoption of a flexible grid will benefit the network design and control plane of future optical networks by providing increased adaptability of spectral resources to heterogeneous network conditions. Unfortunately, this flexibility is gained at the cost of significant additional complexity in the network design and control. In this paper, we consider the optimization of routing and spectrum allocation in FlexiGrid Ring Networks and explore the trade-off between network cost (in terms of spectrum and transponder utilization) and problem complexity (in terms of number of variables/constraints and computational time). Such tradeoffs are investigated under multiple assumptions in terms of traffic grooming, regeneration, and modulation/baud rate assignment capabilities and contrasted to the case of Fixed grid. We show how in presence of traffic grooming the additional complexity due to the flexible grid has a minor impact on problem complexity. Similarly, in all the considered scenarios, regeneration and modulation/baud rate assignment do not relevantly impact problem complexity. We also consider two possible alternative Integer Linear Programming models: the slice-based and the channel-based approach. The former handles each slice individually, whereas the latter uses precomputed subsets of contiguous slices of different bandwidths. Both models are solved under several different network settings. Complexity comparison of the ILP models shows that the slice-based approach provides better performance than the channel-based approach, and that the performance gap between the two models increases with introduction of additional flexibility and dimensions

Comparison between Conventional and Digital Workflow in Implant Prosthetic Rehabilitation: A Randomized Controlled Trial

The progress of digital technologies in dental prosthodontics is fast and increasingly accurate, allowing practitioners to simplify their daily work. These technologies aim to substitute conventional techniques progressively, but their real efficiency and predictability are still under debate. Many systematic reviews emphasize the lack of clinical RCTs that compare digital and traditional workflow. To address this evidence, we conducted a three-arm designed clinical RCT, which compares fully digital, combined digital, and analogic and fully analog workflows. We aimed to compare the clinical properties of each workflow regarding interproximal (IC) and occlusal contact (OC), marginal fit, impression time (IT), and patient satisfaction through a VAS scale. In total, 72 patients were included in the study. The IC and OC of the digital workflow were better than the others (p p = 0.5966). The IT was shorter in the digital workflow than the others (p < 0.001), which were similar. Patient satisfaction was higher in the digital workflow than in the conventional one. Despite the limitations, this study’s results support better accuracy and patient tolerance of digital workflow than of conventional techniques, suggesting it as a viable alternative to the latter when performed by clinicians experienced in digital dentistry