Non-IBD colitides: clinically useful histopathological clues.

Apart from inflammatory bowel diseases (IBD), there are several other form of colitis that may resemble macroscopically IBD, entering the differential diagnosis. These forms are represented by infectious colitis, ischemic colitis, pseudomembranous colitis, colitis related to diverticular disease, colitis related to mucosal prolapse, drug colitis, allergic colitis, and microscopic colitis. However, to distinguish between these forms is not always easy, and it frequently requires a strict interrelationship between the pathologist and the gastroenterologist. Here we discuss the more frequent forms of non- inflammatory bowel diseases colitides, trying to give useful hints for helping the clinician to better understand the extent to which the pathologist is called to give a definitive response in the differential diagnosis of these entities

Composition of Ragusano Cheese During Aging

Ragusano cheese is a brine-salted pasta filata cheese. Composition changes during 12 mo of aging were determined. Historically, Ragusano cheese has been aged in caves at 14 to 16 degrees C with about 80 to 90% relative humidity. Cheeses (n = 132) included in our study of block-to-block variation were produced by 20 farmhouse cheese makers in the Hyblean plain region of the Province of Ragusa in Sicily. Mean initial cheese block weight was about 14 kg. The freshly formed blocks of cheese before brine salting contained about 45.35% moisture, 25.3% protein, and 25.4% fat, with a pH of 5.25. As result of the brining and aging process, a natural rind forms. After 12 mo of aging, the cheese contained about 33.6% moisture, 29.2% protein, 30.0% fat, and 4.4% salt with a pH of 5.54, but block-to-block variation was large. Both soluble nitrogen content and free fatty acid (FFA) content increased with age. The pH 4.6 acetate buffer and 12% TCA-soluble nitrogen as a percentage of total nitrogen were 16 and 10.7%, respectively, whereas the FFA content was about 643 mg/100 g of cheese at 180 d. Five blocks of cheese were selected at 180 d for a study of variation within block. Composition variation within block was large; the center had higher moisture and lower salt in moisture content than did the outside. Composition variation within blocks favored more proteolysis and softer texture in the center

Duodenal metastasis from male breast cancer: a case report and review of the literature

<p>Abstract</p> <p>Introduction</p> <p>Breast cancer is the most frequent type of tumor and the second leading cause of death in women. Metastases are present in nearly 60% of cases at the time of diagnosis with the lymph nodes, skeleton, lungs, brain and liver as the most frequent sites of metastases. Gastrointestinal involvement is rare, present in only 10% of all the cases. There is a very low risk of developing breast cancer in men.</p> <p>Case presentation</p> <p>A 68-year-old man, with a past history of ductal breast cancer, presented with duodenal obstruction. Medical treatment was attempted without success, so he underwent surgery with subtotal gastrectomy and resection of the first portion of the duodenum. Histological examination showed a duodenal metastasis originating from the previous carcinoma of the breast. Five months after surgery, the patient is alive and well.</p> <p>Conclusion</p> <p>Gastrointestinal metastases should be considered in patients with a past history of breast cancer. Surgical treatment should be performed in patients who are symptomatic and in good general condition. To our knowledge this is the only case of a gastrointestinal metastasis from breast carcinoma in a man.</p

Effects of Energy Drink Acute Assumption in Gastrointestinal Tract of Rats

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Demographic, clinical, and service-use characteristics related to the clinician’s recommendation to transition from child to adult mental health services

Purpose: The service configuration with distinct child and adolescent mental health services (CAMHS) and adult mental health services (AMHS) may be a barrier to continuity of care. Because of a lack of transition policy, CAMHS clinicians have to decide whether and when a young person should transition to AMHS. This study describes which characteristics are associated with the clinicians’ advice to continue treatment at AMHS. Methods: Demographic, family, clinical, treatment, and service-use characteristics of the MILESTONE cohort of 763 young people from 39 CAMHS in Europe were assessed using multi-informant and standardized assessment tools. Logistic mixed models were fitted to assess the relationship between these characteristics and clinicians’ transition recommendations. Results: Young people with higher clinician-rated severity of psychopathology scores, with self- and parent-reported need for ongoing treatment, with lower everyday functional skills and without self-reported psychotic experiences were more likely to be recommended to continue treatment. Among those who had been recommended to continue treatment, young people who used psychotropic medication, who had been in CAMHS for more than a year, and for whom appropriate AMHS were available were more likely to be recommended to continue treatment at AMHS. Young people whose parents indicated a need for ongoing treatment were more likely to be recommended to stay in CAMHS. Conclusion: Although the decision regarding continuity of treatment was mostly determined by a small set of clinical characteristics, the recommendation to continue treatment at AMHS was mostly affected by service-use related characteristics, such as the availability of appropriate services

Cohort profile : demographic and clinical characteristics of the MILESTONE longitudinal cohort of young people approaching the upper age limit of their child mental health care service in Europe

Purpose: The presence of distinct child and adolescent mental health services (CAMHS) and adult mental health services (AMHS) impacts continuity of mental health treatment for young people. However, we do not know the extent of discontinuity of care in Europe nor the effects of discontinuity on the mental health of young people. Current research is limited, as the majority of existing studies are retrospective, based on small samples or used non-standardised information from medical records. The MILESTONE prospective cohort study aims to examine associations between service use, mental health and other outcomes over 24 months, using information from self, parent and clinician reports. Participants: Seven hundred sixty-three young people from 39 CAMHS in 8 European countries, their parents and CAMHS clinicians who completed interviews and online questionnaires and were followed up for 2 years after reaching the upper age limit of the CAMHS they receive treatment at. Findings to date: This cohort profile describes the baseline characteristics of the MILESTONE cohort. The mental health of young people reaching the upper age limit of their CAMHS varied greatly in type and severity: 32.8% of young people reported clinical levels of self-reported problems and 18.6% were rated to be ‘markedly ill’, ‘severely ill’ or ‘among the most extremely ill’ by their clinician. Fifty-seven per cent of young people reported psychotropic medication use in the previous half year. Future plans: Analysis of longitudinal data from the MILESTONE cohort will be used to assess relationships between the demographic and clinical characteristics of young people reaching the upper age limit of their CAMHS and the type of care the young person uses over the next 2 years, such as whether the young person transitions to AMHS. At 2 years follow-up, the mental health outcomes of young people following different care pathways will be compared. Trial registration number: NCT03013595

Increasing pasture intakes enhances polyunsaturated fatty acids and lipophilic antioxidants in plasma and milk of dairy cows fed total mix ration

Polyunsaturated fatty acids and lipo-soluble vitamins in the milk are considered as neutraceutical compounds due to their beneficial effects on human health. The aim of the present study was to evaluate the changes in fatty acid composition and fat-soluble antioxidant content in plasma and milk from cows fed with different dietary proportions from pasture. Cows from a farm in the Hyblean mountain region in Italy were randomly divided into three groups (12 animals per group): CTRL fed only a total mix ration (TMR); 30P fed a TMR supplemented with 30% dry matter (DM) from pasture and 70P fed a TMR supplemented with 70% DM of pasture. Blood and milk samples were collected, stored and analysed for their content of fatty acids and fat-soluble antioxidants. Fatty acid profiles were significantly modified by different diets. CLA, vaccenic acid (VA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) significantly (P < 0.05) increased in plasma as a function of the proportion of pasture added to the diet. In agreement with these data, a progressively significant (P < 0.05) increase in concentrations of VA, CLA and EPA was observed in the milk. Such changes in fatty acid composition were accompanied by a concomitant increase in the concentrations of α-tocopherol and β-carotene in both plasma and milk. The increase in EPA, DHA and CLA, β-carotene and α-tocopherol in plasma may not only have a beneficial impact for milk and meat quality, but may also result in an increased protection against inflammatory events

Comparison of Techniques for Maintaining Adequate Disinfectant Residuals in a Full-Scale Water Distribution Network

The present work provides a numerical comparison of different techniques that can be adopted to guarantee sufficient disinfectant residuals in a water distribution network (WDN) when chlorine or chloramine is used as disinfectant. First, while considering chlorine as a disinfectant, the implementation of booster stations in bulk areas and continuous outflows at dead-end nodes was considered. Afterward, the comparison between continuous and intermittent outflows was performed. The water volume being the same, water is provided through blowoffs for 24 h or for limited durations, respectively. Finally, the extent to which the results change was analyzed when chloramine is used instead of chlorine. The methodology is based on the use of the flow routing/water quality modeling software EPANET and its multispecies extension EPANET-MSX on a full-scale WDN. The results show that all the operational measures analyzed are effective to tackle the problem of low disinfectant residuals in WDN. Booster stations are effective to obtain a more uniform distribution of disinfectant throughout the WDN, while nodal blowoffs seem to be a necessary solution for the numerous and scattered dead-end nodes of WDN. The use of chloramine yielded a decrease in the number of blowoffs to open and in blowoff outflows

Dealing with crowd crystals in MAS-based crowd simulation: A proposal

The paper presents an agent-based model for the explicit representation of groups of pedestrians in a crowd. The model is the result of a multidisciplinary research (CRYSTALS project) where multicultural dynamics and spatial and socio-cultural relationships among individuals are considered as first class elements for the simulation of crowd of pilgrims taking to the annual pilgrimage towards Makkah. After an introduction of advantages of Multi-Agent System approach for pedestrian dynamics modelling, a formal description of the model is proposed. The scenario in which the model was developed and some examples about modelling heterogeneous groups of pedestrians are described

Comparison of Techniques for Maintaining Adequate Disinfectant Residuals in a Full-Scale Water Distribution Network

The present work provides a numerical comparison of different techniques that can be adopted to guarantee sufficient disinfectant residuals in a water distribution network (WDN) when chlorine or chloramine is used as disinfectant. First, while considering chlorine as a disinfectant, the implementation of booster stations in bulk areas and continuous outflows at dead-end nodes was considered. Afterward, the comparison between continuous and intermittent outflows was performed. The water volume being the same, water is provided through blowoffs for 24 h or for limited durations, respectively. Finally, the extent to which the results change was analyzed when chloramine is used instead of chlorine. The methodology is based on the use of the flow routing/water quality modeling software EPANET and its multispecies extension EPANET-MSX on a full-scale WDN. The results show that all the operational measures analyzed are effective to tackle the problem of low disinfectant residuals in WDN. Booster stations are effective to obtain a more uniform distribution of disinfectant throughout the WDN, while nodal blowoffs seem to be a necessary solution for the numerous and scattered dead-end nodes of WDN. The use of chloramine yielded a decrease in the number of blowoffs to open and in blowoff outflows