Practice parameters for the treatment of colonic diverticular disease: Italian Society of Colon and Rectal Surgery (SICCR) guidelines

The mission of the Italian Society of Colorectal Surgery (SICCR) is to optimize patient care. Providing evidence-based practice guidelines is therefore of key importance. About the present report it concernes the SICCR practice guidelines for the diagnosis and treatment of diverticular disease of the colon. The guidelines are not intended to define the sole standard of care but to provide evidence-based recommendations regarding the available therapeutic options

Validation of a 1H-NMR Spectroscopy Quantitative Method to Quantify Trimethylamine Content and K -Index Value in Different Species of Fish

The chemical analysis that is frequently employed for the evaluation of the freshness of fish includes (i) the quantification of trimethylamine (TMA) and (ii) the estimation of the K-Index, based on the ratio between the concentrations of adenosine triphosphate (ATP) and its breakdown products. TMA is quantified using a colorimetric reference method (AOAC), while the K-Index is usually determined by HPLC. The present work proposes a method for the above freshness biomarkers based on HR H-1-NMR as an alternative method able to assess both indexes simultaneously on aqueous fish extracts. To validate the proposed H-1-NMR method, a large set of validation checks has been addressed, such as accuracy, precision, specificity, limits of detection, linearity, and range of linearity and quantification according to EuroChem guidelines. The results show that the methodology satisfies all the validation requirements at the same level as the most frequently used methods, with the advantage of being faster and more repeatable, avoiding the use of solvents, such as toluene and formaldehyde, or dangerous reagents such as picric acid

Editorial on the European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastrointestinal and Abdominal Radiology (ESGAR) guideline on clinical indications for CT colonography in the colorectal cancer diagnosis

European Society of Gastrointestinal Endoscopy (ESGE)-European Society of Gastrointestinal and Abdominal Radiology (ESGAR) guideline was generated jointly by a team of researchers, including gastrointestinal radiologists and endoscopists, and represents the first full collaborative effort between the two specialties after years of turf battles involving CT colonography (CTC) and colonoscopy (CS). This guideline has a main educational purpose and it represents the attempt to find a consensus about the use of CTC in clinical practice based on the best current available evidence. Thus, it should not be considered as rules for establishing a legal standard of care. Main recommendations include the use of CTC as the radiological examination of choice for the diagnosis of colorectal neoplasia, the use of CTC in the case of incomplete CS, and the possible use of CTC as an acceptable and equally sensitive alternative for patients with symptoms suggestive of colorectal cancer (CRC), when CS is contraindicated or not possible. ESGE-ESGAR guideline does not recommend CTC for population screening, but considers that CTC may be proposed as a CRC screening test on an individual basis (opportunistic screening) provided the screenee is adequately informed about test characteristics, benefits and risks. With regard to patient management, referral for endoscopic polypectomy in patients with at least one polyp ≥6 mm in diameter detected at CTC is recommended, considering surveillance only in case polyp removal is not possible. Knowledge about CTC is in continuous evolution and this means that a revision might be necessary in the future as new data appear

Hepatocellular carcinoma in adult thalassemia patients: an expert opinion based on current evidence

Beta-thalassemia represents a heterogeneous group of haemoglobin inherited disorders, among the most common genetic diseases in the world, frequent in the Mediterranean basin. As beta-thalassemia patients' survival has increased over time, previously unknown complications are observed with increasing frequency. Among them, an increased risk of hepatocellular carcinoma (HCC) has been registered. Our aim is to reduce inequalities in diagnosis and treatment and to offer patients univocal recommendations in any institution. The members of the panel - gastroenterologists, radiologists, surgeons and oncologists -were selected on the basis of their publication records and expertise. Thirteen clinical questions, derived from clinical needs, and an integration of all the committee members' suggestions, were formulated. Modified Delphi approach involving a detailed literature review and the collective judgement of experts, was applied to this work. Thirteen statements were derived from expert opinions' based on the current literature, on recently developed reviews and on technological advancements. Each statement is discussed in a short paragraph reporting the current key evidence. As this is an emerging issue, the number of papers on HCC in beta-thalassemia patients is limited and based on anecdotal cases rather than on randomized controlled studies. Therefore, the panel has discussed, step by step, the possible differences between beta-thalassemia and non beta-thalassemia patients. Despite the paucity of the literature, practical and concise statements were generated. This paper offers a practical guide organized by statements describing how to manage HCC in patients with beta-thalassemia

Application of imaging guidelines in patients with foreign body ingestion or inhalation: literature review

Ingestion, inhalation, and insertion of foreign bodies (FBs) are very common clinical occurrences. In any case, early diagnosis and prompt management are mandatory to avoid severe and life-threatening complications. Radiologists have an important role in revealing the presence, dimension, nature, and relationship with anatomical structures of a FB; selecting the most appropriate imaging modality; and enabling the best therapeutic choice. This review article focuses on the most frequent FBs ingested, inhaled, and inserted and presents the different tests and investigations to provide a correct radiological approach

State of the art: iterative CT reconstruction techniques

Owing to recent advances in computing power, iterative reconstruction (IR) algorithms have become a clinically viable option in computed tomographic (CT) imaging. Substantial evidence is accumulating about the advantages of IR algorithms over established analytical methods, such as filtered back projection. IR improves image quality through cyclic image processing. Although all available solutions share the common mechanism of artifact reduction and/or potential for radiation dose savings, chiefly due to image noise suppression, the magnitude of these effects depends on the specific IR algorithm. In the first section of this contribution, the technical bases of IR are briefly reviewed and the currently available algorithms released by the major CT manufacturers are described. In the second part, the current status of their clinical implementation is surveyed. Regardless of the applied IR algorithm, the available evidence attests to the substantial potential of IR algorithms for overcoming traditional limitations in CT imaging

Lack of mutation at codon 531 of SRC in advanced colorectal cancers from Italian patients

A truncating mutation (C to T transition) at codon 531 of the human protooncogene c-src, possibly accounting for the activation of c-src tyrosine kinase, has been recently identified in a subset of advanced colorectal cancer from North-American patients. However, two subsequent studies have failed to confirm the occurrence of SRC 531 mutation in colorectal cancers from North-European and Asiatic patients, raising the hypothesis that the genetic activation of src in colon cancer might be restricted to patients belonging to specific ethnic groups. We investigated a large series of colorectal cancers from Italian patients (155 cases) with a high prevalence of liver metastasis (43%). Using a PCR-RFLP assay, the occurrence of a SRC 531 mutation was ruled out in all the investigated specimens of primary tumours and/or metastases. Our results demonstrate that SRC Gln531AMB plays no role in the development or in the progression of colorectal cancer among Italian patients. © 2001 Cancer Research Campaign http://www.bjcancer.co

An environmental sustainability roadmap for partially substituting agricultural waste for sand in cement blocks

Agricultural waste can be used in cement block production for a number of reasons, including its environmental, economic, and labor benefits. This study examines the mechanical, durability, and cost-effectiveness characteristics of cement blocks. A cement block made from agriculture waste promotes sustainable construction practices, since waste agriculture is often dumped in landfills and regarded as a waste material. Carbon dioxide (CO2) emissions produced by the construction sector, either from the firing of clay bricks or from the production of cement, contribute significantly to global warming. In many developing countries, air pollution from agricultural activities is primarily accounted for the emissions from agricultural machinery and openly burning agro-waste. Farming is one of the leading causes of water and soil pollution. Hence, adopting agricultural waste into cement production would significantly reduce the environmental impact of concrete structures. The goal of this research is to determine whether agricultural waste products, such as vermiculite, pistachio shells, sugarcane bagasse, and coconut husks, can be used to substitute sand in concrete blocks. The water absorption capacity of waste materials, density, flexural strength, fire resistance, and compressive strength of waste materials as admixtures in concrete were evaluated using experimental tests. In most cases, the concrete blocks made from agricultural waste were strong enough to satisfy ASTM standards. The specimens containing coconut husks and pistachio shells, among others, were found to be fairly strong and durable, even when isolating them from water