The prevalence of malignant neoplastic and non-malignant gastrointestinal lesions in cardiology inpatients

AbstractBackgroundAlthough gastrointestinal (GI) complications are receiving more attention in cardiovascular patients owing to the widespread use of antithrombotic drugs, information seems to be limited over the prevalence of GI malignancies in those patients.Methods and resultsThe prevalence of malignant as well as non-malignant GI lesions diagnosed in cardiology inpatients was investigated. We retrospectively analyzed 274 cardiology inpatients who underwent upper and/or lower GI tract endoscopies. A total of 97 patients (35.4%) were taking multiple antithrombotic drugs and the mean number of antithrombotic drugs used was 1.19. Malignant neoplasm was found in 26 patients (9.5%), and non-malignant lesions (ulcers, adenomas, polyps) were found in 106 patients (38.7%). Multivariate analysis showed that antiplatelet drug usage was negatively (odds ratio [OR] 0.38, 95% confidence interval [CI] 0.16–0.91) whereas positive fecal occult blood test was positively (OR 4.44, 95% CI 1.44–13.66) associated with GI malignancies. On the other hand, for non-malignant GI lesions, both antiplatelet drug usage (OR 1.85, 95% CI 1.05–3.25) and positive fecal occult blood test (OR 1.99, 95% CI 1.14–3.47) were found to be positive predictors.ConclusionsDuring the 59-month study period, 26 and 106 patients were diagnosed to have GI malignancies and non-malignant GI lesions, respectively, among cardiology inpatients. Cardiology physicians should not overlook the possibility of GI malignancies in an era of multiple antithrombotic drug usage

Vascular composition data supporting the role of N-3 polyunsaturated fatty acids in the prevention of cardiovascular disease events

AbstractN-3 polyunsaturated fatty acids (PUFAs) are thought to have protective effects against cardiovascular disease. Here, we report the relationship between serum PUFA concentrations and plaque composition, as evaluated by virtual histology-intravascular ultrasound (VH-IVUS). Consecutive patients (n=61) who underwent percutaneous coronary intervention (PCI) were pre-operatively examined using VH-IVUS to assess the composition of culprit plaques. Gray-scale IVUS and VH-IVUS data of fibrous, fibro-fatty, necrotic core, and dense calcium regions of plaques were estimated at the minimal luminal area sites of culprit lesions. Serum levels of high-sensitivity C-reactive protein (hsCRP) and PUFAs, including eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and arachidonic acid (AA), were compared between patients with (ACS, n=27) and without acute coronary syndrome (non-ACS, n=34) before PCI. Multiple logistic regression analysis of the data showed that EPA/AA under the median was more highly associated with ACS than hsCRP over the median. In addition, EPA/AA was negatively correlated with the percentage of fibrous plaque regions and EPA/AA and DHA/AA were positively correlated with the percentage of dense calcium regions in plaques. Furthermore, the correlation index of EPA/AA was the most highly (R=0.513) correlated with the percentage of dense calcium regions in plaques

A case of acute myocardial infarction during perioperative period of non-cardiac surgery in a patient with antiphospholipid syndrome and a history of coronary artery bypass surgery

AbstractA 65-year-old woman underwent coronary artery bypass surgery and was diagnosed with antiphospholipid syndrome (APS) at the same time in 1985. She was admitted to our hospital to undergo mastectomy for left breast cancer in 2012. She was put on intravenous infusion of heparin and stopped receiving both antiplatelet agents and warfarin. The operation was performed without complications, and antithrombotic therapy was restarted one day after the operation. On day 6 postoperative, she complained of sudden chest pain and on examination she was diagnosed with acute myocardial infarction. The culprit lesion was in a saphenous vein graft and coronary intervention was performed.<Learning objective: Antithrombotic therapy for patients with APS is complicated because of prolonged baseline activated partial thromboplastin time (aPTT). An effective perioperative antithrombotic therapy for APS patients who have a history of coronary artery disease and have undergone non-cardiac surgery has not yet been established. A safe strategy for such a therapy should therefore be discussed.

A Case of Benign Schwannoma of the Transverse Colon with Granulation Tissue

Schwannomas occurring in the gastrointestinal tract are rare, and among them, schwannomas of the large intestine are extremely rare. In this paper, we report a case of a macroscopically atypical schwannoma of the transverse colon. The case is a female aged 67. Stool occult blood test was positive, and colonoscopy revealed a protruded lesion resembling a type 1 carcinoma measuring 4 cm with a reddish and uneven surface on the transverse colon. The surface was smooth and lobulated in observation with indigo carmine spray, and granulation tissue was revealed by biopsies. CT of the abdomen showed an irregular mass, and clinical examinations could not rule out malignancy. Therefore, partial transverse colectomy with peripheral lymph node dissection was performed. Histologically, proliferation of spindle cells was observed originating from the muscularis propria, and most of the upper part of the lesion was replaced by granulation tissue. In immunohistochemical staining, S-100 protein and NSE were positive while KIT, CD34, desmin and smooth muscle actin were negative, and the tumor was therefore diagnosed to be a schwannoma. In addition, since the MIB-1 labeling index was low and virtually no mitosis was observed, it was diagnosed as benign tumor

Prevalence and cumulative incidence of autism spectrum disorders and the patterns of co-occurring neurodevelopmental disorders in a total population sample of 5-year-old children.

BackgroundsWhether there is a true increase in autism spectrum disorder (ASD) frequency or not remains unclear. Additionally, the rates of co-existing neurodevelopmental disorders (NDD) in a total population sample has not been fully examined before. Therefore, using a total population sample in Japan, we aimed to estimate the prevalence and cumulative incidence of autism spectrum disorder (ASD) annually, to determine whether there is a true increase in ASD prevalence by estimating the cumulative incidence of ASD annually, and to examine the rates of co-existing neurodevelopmental disorders (NDD).MethodIn this cross-sectional sequential design study, all 5-year-old children in the catchment area underwent the screening annually from the year 2013-2016. Screen-positive children were invited to participate in a comprehensive assessment, including child and parent interview, behavioral observation, and cognitive and motor function testing. All cases were reviewed by a multidisciplinary research team.ResultsCaregivers of 3954 children returned the screening, among which 559 children underwent the assessment with 87 children receiving an ASD diagnosis. Adjusted ASD prevalence was 3.22% (95% confidence interval (CI) 2.66-3.76%). The male to female ratio of the crude prevalence was 2.2:1. The cumulative incidence of ASD up to 5 years of age for the total study years was 1.31% (95% CI 1.00-1.62%). A generalized linear model revealed no significant linear trends in 5-year cumulative incidence over the study years. Only 11.5% of children had ASD alone; the remaining 88.5% were found to have at least one co-existing NDD.LimitationsModest sample size for a total population study.ConclusionsOur findings demonstrate the stability of the 5-year cumulative incidence of ASD, implying no true rise in ASD incident cases over the 4-year study period in the study catchment area. High rates of co-existing NDDs reflect the importance of investigating broad developmental challenges in children with ASD

Areion: Highly-Efficient Permutations and Its Applications (Extended Version)

In real-world applications, the overwhelming majority of cases require (authenticated) encryption or hashing with relatively short input, say up to 2K bytes. Almost all TCP/IP packets are 40 to 1.5K bytes, and the maximum packet lengths of major protocols, e.g., Zigbee, Bluetooth low energy, and Controller Area Network (CAN), are less than 128 bytes. However, existing schemes are not well optimized for short input. To bridge the gap between real-world needs (in the future) and limited performances of state-of-the-art hash functions and authenticated encryptions with associated data (AEADs) for short input, we design a family of wide-block permutations Areion that fully leverages the power of AES instructions, which are widely deployed in many devices. As for its applications, we propose several hash functions and AEADs. Areion significantly outperforms existing schemes for short input and even competitive to relatively long messages. Indeed, our hash function is surprisingly fast, and its performance is less than three cycles/byte in the latest Intel architecture for any message size. It is significantly much faster than existing state-of-the-art schemes for short messages up to around 100 bytes, which are the most widely-used input size in real-world applications, on both the latest CPU architectures (IceLake, Tiger Lake, and Alder Lake) and mobile platforms (Pixel 7, iPhone 14, and iPad Pro with Apple M2)

Clinical characteristics and visual outcomes of work-related open globe injuries in Japanese patients

Purpose: To investigate the clinical characteristics and visual outcomes of patients with work-related open globe injuries (OGIs) and compare them with patients with non-work-related OGIs. Design: Retrospective, observational, multicentre, case-control study. Methods: A total of 374 patients with work-related OGIs and 170 patients with non-work-related OGIs who presented to hospitals that belong to the Japan-Clinical Research of Study group from 2005 to 2015 were included in this study. Clinical data including age, sex, initial and final visual acuity, type of open globe injury, lens status, zone of injury, wound length, and presence of proliferative vitreoretinopathy, retinal detachment, expulsive haemorrhage, and endophthalmitis were recorded. Main Outcome Measures: Visual acuity. Results Work-related OGIs were associated with younger age, male sex, better initial and final visual acuity, more laceration, smaller wounds, presence of retinal detachment, and expulsive haemorrhage, compared with non-work-related OGIs. Multiple regression analysis revealed that final visual acuity is significantly associated with initial visual acuity, wound length, and the presence of proliferative vitreoretinopathy in work-related OGIs. Conclusions: Work-related OGIs showed better visual outcomes than other OGIs. Initial visual acuity, wound length, and the presence of proliferative vitreoretinopathy are predictors of visual outcomes in patients with work-related OGIs

Flat-band ferromagnetism induced by off-site repulsions

Density matrix renormalization group method is used to analyze how the nearest-neighbor repulsion V added to the Hubbard model on 1D triangular lattice and a railway trestle (t-t') model will affect the electron-correlation dominated ferromagnetism arising from the interference (frustration). Obtained phase diagram shows that there is a region in smaller-t' side where the critical on-site repulsion above which the system becomes ferromagnetic is reduced when the off-site repulsion is introduced.Comment: 4 pages, RevTex, 6 figures in Postscript, to be published in Phys. Rev.