Indications for colonoscopy An analysis based on indications and diagnostic yield

Open access colonoscopy for patients with suspected colonic disease is often not practical and some fonn of patient selection may be necessary. One year's colonoscopic data from our unit were analysed to determine the major indications for the procedure and the diagnostic yield, and to evaluate the suitability of colonoscopy for each indication. The seven major indications were rectal bleeding, iron deficiency anaemia, cancer follow-up, polyp follow-up, abdominal pain, abnormal bowel habit and 'other'. Four hundred and forty-eight procedures were included in the analysis, with rectal bleeding, polyp follow-up and iron deficiency anaemia producing the highest diagnostic yields of 69,1%, 53,3% and 47,7% respectively. Lower yields were obtained for cancer follow-up (21%), abdominal pain (38,2%) and abnormal bowel habit (46,8%). The indication, 'other', produced a combined yield of 66,7%; the majority of patients in this group were known to have colitis. On the basis of these findings we propose that where facilities and expertise do not allow for routine colonoscopy, some fonn ofpatient selection should be employed and we believe this selection should take place according to the diagnostic yield for each indication

Mobility of stretched water

To study the mobility of stretched SPC/E water and its dependence on temperature and density, five molecular dynamics computer simulation runs were performed. Three runs were performed at temperature 300 K and densities 1.0, 0.9, and 0.8 g/cc. Two more runs were performed at temperature 273 K and densities 1.0 and 0.9 g/cc. At temperature 300 K, the translational diffusion coefficient of the stretched SPC/E water increased with the stretch, at temperature 273 K the translational diffusion decreased with the stretch. This behavior is correlated with the observed changes in the hydrogen bonding pattern of water.To study the mobility of stretched SPC/E water and its dependence on temperature and density, five molecular dynamics computer simulation runs were performed. Three runs were performed at temperature 300 K and densities 1.0, 0.9, and 0.8 g/cc. Two more runs were performed at temperature 273 K and densities 1.0 and 0.9 g/cc. At temperature 300 K, the translational diffusion coefficient of the stretched SPC/E water increased with the stretch, at temperature 273 K the translational diffusion decreased with the stretch. This behavior is correlated with the observed changes in the hydrogen bonding pattern of water

Heme oxygenase-1 as a modulator of intestinal inflammation development and progression

Indexación: Scopus.Heme Oxygenase 1 (HMOX1) is an enzyme that catalyzes the reaction that degrades the heme group contained in several important proteins, such as hemoglobin, myoglobin, and cytochrome p450. The enzymatic reaction catalyzed by HMOX1 generates Fe2+, biliverdin and CO. It has been shown that HMOX1 activity and the by-product CO can downmodulate the damaging immune response in several models of intestinal inflammation as a result of pharmacological induction of HMOX1 expression and the administration of non-toxic amounts of CO. Inflammatory Bowel Diseases, which includes Crohn's Disease (CD) and Ulcerative Colitis (UC), are one of the most studied ailments associated to HMOX1 effects. However, microbiota imbalances and infections are also important factors influencing the occurrence of acute and chronic intestinal inflammation, where HMOX1 activity may play a major role. As part of this article we discuss the immune modulatory capacity of HMOX1 during IBD, as well during the infections and interactions with the microbiota that contribute to this inflammatory disease. © 2018 Sebastián, Salazar, Coronado-Arrázola, Schultz, Vallejos, Berkowitz, álvarez-Lobos, Riedel, Kalergis and Bueno.https://www.frontiersin.org/articles/10.3389/fimmu.2018.01956/ful

Evidence for Possible Phase-Separations in RuSr2(Gd,Ce)2Cu2O10-delta

An unusual thermal-magnetic hysteresis was observed between a minor magnetic transition around 120 K and the main one at 80 K in superconducting RuSr2(R,Ce)2Cu2O10-delta (Ru1222R) samples, where R = Gd or Eu, down to a submicron length-scale. The observation suggests a possible phase-separation and is consistent with the very small but universal demagnetizing factor observed, which is difficult to reconcile with the canted spin-structure previously proposed. In such a scenario, the unusual superconducting properties of the Ru-based cuprates can also be understood naturally.Comment: 8 pages, 3 figures, submitted to Phys. Rev. B, "Rapid Communications" (September 26, 2001

Treatment of Comorbid Obesity and Major Depressive Disorder: A Prospective Pilot Study for their Combined Treatment

Background. Obese individuals who suffer from major depressive disorder are routinely screened out of weight loss trials. Treatments targeting obesity and depression concurrently have not been tested. Purpose. To test the short-term efficacy of a treatment that combined behavioral weight management and cognitive behavioral therapy (CBT) for obese adults with depression. Methods. Twelve obese females diagnosed with major depressive disorder received weekly group behavioral weight management, combined with CBT for depression, for 16 weeks. Weight, symptoms of depression, and cardiovascular disease (CVD) risk factors were measured at baseline and week 16. Results. Participants lost 11.4% of initial weight and achieved significant improvements in symptoms of depression and CVD risk factors. Conclusions. Obese individuals suffering from major depressive disorder can lose weight and achieve improvements in symptoms of depression and CVD risk factors with 16 weeks of combined treatment. A larger randomized controlled trial is needed to establish the efficacy of this treatment

Miscible displacement fronts of shear thinning fluids inside rough fractures

The miscible displacement of a shear-thinning fluid by another of same rheological properties is studied experimentally in a transparent fracture by an optical technique imaging relative concentration distributions. The fracture walls have complementary self-affine geometries and are shifted laterally in the direction perpendicular to the mean flow velocity {\bf U} : the flow field is strongly channelized and macro dispersion controls the front structure for P\'{e}clet numbers above a few units. The global front width increases then linearly with time and reflects the velocity distribution between the different channels. In contrast, at the local scale, front spreading is similar to Taylor dispersion between plane parallel surfaces. Both dispersion mechanisms depend strongly on the fluid rheology which shifts from Newtonian to shear-thinning when the flow rate increases. In the latter domain, increasing the concentration enhances the global front width but reduces both Taylor dispersion (due to the flattening of the velocity profile in the gap of the fracture) and the size of medium scale front structures

Amonafide: An active agent in the treatment of previously untreated advanced breast cancer--a cancer and leukemia group B study (CALGB 8642)

Amonafide is a new imide derivative of naphthalic acid. The drug had demonstrated significant activity in preclinical studies and some activity in Phase I trials. The drug is extensively metabolized and detected in plasma and urine. Its toxicity has previously been correlated to the formation of an active metabolite, N-acetyl-amonafide. Amonafide was chosen for inclusion in the Cancer and Leukemia Group B (CALGB) master metastatic breast cancer protocol. CALGB 8642 randomizes previously untreated metastatic breast cancer patients either to one of several Phase II agents given for up to four cycles and then followed by standard cyclophosphamide-doxorubicin-5-fluorouracil, or to immediate treatment with standard cyclophosphamide-doxorubicin-5-fluorouracil. The end point of CALGB 8642 is to assess the difference in survival, toxicity, and overall response when limited exposure to Phase II agents precedes standard chemotherapy. This report deals only with amonafide as a Phase II agent. Comparisons with the cyclophosphamide-doxorubicin-5-fluorouracil arm will not be addressed. Patients had to have histologically documented measurable breast cancer and a performance status of 0-1. Patients could not have had prior chemotherapy for metastatic disease. Prior adjuvant chemotherapy was permitted. Patients could not have visceral crisis. Amonafide was given at 300 mg/m2/day i.v. for 5 days, and repeated at 21-day intervals for a maximum of four cycles. Escalation and reduction in dose was mandated dependent on hematotoxicity or lack thereof. Toxicity was primarily hematological and bimodal: 32% had grade 3 or 4 leukopenia and 24% had grade 3 or 4 thrombocytopenia; 22% had no leukopenia and 44% had no thrombocytopenia. The response rate was 18%, including one complete response. When response was analyzed by hematological toxicity, there was a 35.7% response if patients had leukopenia grade 3/4 (versus 8.3%, P = 0.08). There was a 50% response if patients had thrombocytopenia grade 3/4 (versus 7.1%, P = \u3c0.01). We conclude that amonafide is somewhat active in previously untreated breast cancer patients. There may be a steep dose-response curve, based on the significant correlation between myelosuppression and response. Rates of responses in patients adequately dosed (i.e., with significant hematotoxicity) with amonafide ranged from 35 to 50%. Further studies will incorporate individualized dosing based on pretreatment acetylator phenotyping