Translocation of the conus medullaris during dynamic lumbosacral magnetic resonance imaging in dogs

OBJECTIVE To investigate the change in the lumbosacral angle (Delta LSA) and conus medullaris (CM) displacement in healthy dogs undergoing dynamic MRI with changes in the posture of their pelvic limbs from neutral posture to flexion or extension posture and to evaluate for potential correlation between Delta LSA and CM displacement. ANIMALS 9 healthy adult Beagles. PROCEDURES Dogs underwent dynamic MRI with their pelvic limbs positioned in neutral, flexion, and extension postures. From T2-weighted sagittal midline plane MRI images, 2 observers measured the lumbosacral angle and CM location in duplicate for each posture for each dog. Intra- and interobserver agreement was assessed, and the Spearman rank correlation coefficient (rho) was used to assess for potential correlation between Delta LSA and CM displacement for changes in pelvic limb posture from neutral to flexion or extension. RESULTS Overall, the mean Delta LSA and CM displacement for changes in posture were 23 degrees and 9.09 mm (caudal displacement) for the change from neutral to flexion posture, 8.4 degrees and -2.5 mm (cranial displacement) for the change from neutral to extension posture, and 32.2 degrees and 11.64 mm (caudal displacement) for the change from extension to flexion posture. The Delta LSA strongly correlated (p = 0.705: 95% CI, 0.434 to 0.859) with displacement of the CM. CONCLUSIONS AND CLINICAL RELEVANCE The use of dynamic MR1, compared with conventional MRI, will better help to characterize clinically normal and abnormal features of the lumbosacral region of the vertebral column and associated spinal cord during postural changes. Further, when limited translocation of the CM is evident on dynamic MRI, veterinarians should suspect underlying lumbosacral pathophysiologic processes or anatomic abnormalities.Y

Miss rate of colorectal neoplastic polyps and risk factors for missed polyps in consecutive colonoscopies

Background/Aims: Colonoscopic polypectomy is the best diagnostic and therapeutic tool to detect and prevent colorectal neoplasms. However, previous studies have reported that 17% to 28% of colorectal polyps are missed during colonoscopy. We investigated the miss rate of neoplastic polyps and the factors associated with missed polyps from quality-adjusted consecutive colonoscopies.Methods: We reviewed the medical records of patients who were found to have colorectal polyps at a medical examination center of the Kangbuk Samsung Hospital between March 2012 and February 2013. Patients who were referred to a single tertiary academic medical center and underwent colonoscopic polypectomy on the same day were enrolled in our study. The odds ratios (ORs) associated with polyp-related and patient-related factors were evaluated using logistic regression analyses.Results: A total of 463 patients and 1,294 neoplastic polyps were analyzed. The miss rates for adenomas, advanced adenomas, and carcinomas were 24.1% (312/1,294), 1.2% (15/1,294), and 0% (0/1,294), respectively. Flat/sessile-shaped adenomas (adjusted OR, 3.62; 95% confidence interval [CI], 2.40–5.46) and smaller adenomas (adjusted OR, 5.63; 95% CI, 2.84– 11.15 for ≤5 mm; adjusted OR, 3.18; 95% CI, 1.60–6.30 for 6–9 mm, respectively) were more frequently missed than pedunculated/sub-pedunculated adenomas and larger adenomas. In patients with 2 or more polyps compared with only one detected (adjusted OR, 2.37; 95% CI, 1.55–3.61 for 2–4 polyps; adjusted OR, 11.52; 95% CI, 4.61–28.79 for ≥5 polyps, respectively) during the first endoscopy, the risk of missing an additional polyp was significantly higher.Conclusions: One-quarter of neoplastic polyps was missed during colonoscopy. We encourage endoscopists to detect smaller and flat or sessile polyps by using the optimal withdrawal technique

Parameters of Glucose and Lipid Metabolism Affect the Occurrence of Colorectal Adenomas Detected by Surveillance Colonoscopies

El presente trabajo procura dar cuenta, describiendo reflexivamente el caso de las empresas recuperadas en la Argentina, de un tipo de transformaciones en la organización de la demanda y la lucha entablada frente al orden de cosas propuesto por tres décadas de políticas neoliberales monitoreando al Estado.Jornadas realizadas junto con el I Encuentro Latinoamericano de Metodología de las Ciencias Sociales.Facultad de Humanidades y Ciencias de la Educació