Optimal management of constipation associated with irritable bowel syndrome.

Irritable bowel syndrome (IBS) is a common chronic functional disorder of the gastrointestinal tract, meanly characterized by recurrent abdominal pain or discomfort and altered bowel habit. It is a complex disorder involving biological, environmental, and psychosocial factors. The diagnosis is achieved according to the Rome III criteria provided that organic causes have been excluded. Although IBS does not constitute a life-threatening condition, it has a remarkable prevalence and profoundly reduces the quality of life with burdening socioeconomic costs. One of the principal concerns about IBS is the lack of effective therapeutic options. Up to 40% of patients are not satisfied with any available medications, especially those suffering from chronic constipation. A correct management of IBS with constipation should evolve through a global approach focused on the patient, starting with careful history taking in order to assess the presence of organic diseases that might trigger the disorder. Therefore, the second step is to examine lifestyle, dietary habits, and psychological status. On these bases, a step-up management of disease is recommended: from fiber and bulking agents, to osmotic laxative drugs, to new molecules like lubiprostone and linaclotide. Although new promising tools for relief of bowel-movement-related symptoms are being discovered, a dedicated doctor\u2013patient relationship still seems to be the key for succes

Initial operation of the International Gravitational Event Collaboration

The International Gravitational Event Collaboration, IGEC, is a coordinated effort by research groups operating gravitational wave detectors working towards the detection of millisecond bursts of gravitational waves. Here we report on the current IGEC resonant bar observatory, its data analysis procedures, the main properties of the first exchanged data set. Even though the available data set is not complete, in the years 1997 and 1998 up to four detectors were operating simultaneously. Preliminary results are mentioned.Comment: 8 pages, 2 figures, 3 tables; Proceeding of the GWDAW'99. Submitted to the International Journal of Modern Physic

Performance of Delta4 Phantom+ using Flattening-Filter and Flattening Filter-Free beams

EnThe goal of this study was to evaluate the performances of the new pre-treatment system Delta4 Phantom+ in terms of a stable and sensitive tool for achieving a reliable verification. Delta4+ was evaluated for verification with 6FFFMV beams using static beam arrangement. The accelerator output was monitored with the ionization chamber. The device was tested for dose-rate dependence, linearity and stability using its daily output correction. The response of Delta4+ was evaluated for energy 6FFFMV, measuring the gamma index of four Volumetric Modulated Arc Therapy (VMAT) plan. The response of Delta4+ as a function of accelerator dose rate is in agreement with the ionization chamber with a difference smaller than 0,1%. The output is constant for different MU. VMAT plan analysis show values within 98,3%-100% with a threshold of 3%-3mm, while with a threshold of 2%-2mm the values are within 93,5%-97,5%. Delta4+ is an accurate device. For all the measurements made, uncertainties below 1% were obtained.ItLo scopo di questo studio è stato quello di valutare la risposta in termini di stabilità e sensibilità del nuovo sistema pre-trattamento Delta4 Phantom+. La risposta del sistema è stato studiata utilizzando fasci di fotoni da 6MVsenza filtro di flattening (6FFFMV). L'output dell'acceleratore è stato monitorato con una camera a ionizzazione. La dipendenza dal dose rate, la linearità e la stabilità sono state verificate utilizzando il fattore di correzione giornaliera fornito dal sistema. La risposta è stata verificata su 4 piani di trattamento con tecnica VMAT. La risposta del Delta4+ al variare del dose rate è in accordo con quella della camera a ionizzazione con una scarto minore dello 0.1%. La risposta al variare delle UM è costante con una differenza entro lo 0.4%. L'analisi dei piani VMAT mostra valori di indice gamma per soglia 3%-3mm compresi tra 98.3%-100%, mentre per 2%-2mm i valori sono tra 93,5%-97,5%. Il Delta4+ risulta essere un sistema accurato in quanto l'incertezza ottenuta su tutte le misure non supera l'1%

Younger age at onset and sex predict celiac disease in children and adolescents with type 1 diabetes: an Italian multicenter study

OBJECTIVE— To estimate the prevalence of biopsy-confirmed celiac disease in Italian children and adolescents with type 1 diabetes and to assess whether age at onset of type 1 diabetes is independently associated with diagnosis of celiac disease. RESEARCH DESIGNANDMETHODS— The study group was a clinic-based cohort of children and adolescents with type 1 diabetes cared for in 25 Italian centers for childhood diabetes. Yearly screening for celiac disease was performed using IgA/IgG anti-gliadin and IgA anti-endomysium antibodies. RESULTS— Of the 4,322 children and adolescents (age 11.8 4.2 years) identified with type 1 diabetes, biopsy-confirmed celiac disease was diagnosed in 292 (prevalence 6.8%, 95% confidence interval [CI] 6.0 –7.6), with a higher risk seen in girls than in boys (odds ratio [OR] 1.93, 1.51–2.47). In 89% of these, diabetes was diagnosed before celiac disease. In logistic regression analyses, being younger at onset of diabetes, being female, and having a diagnosis of a thyroid disorder were independently associated with the risk of having diabetes and celiac disease. In comparison with subjects who were older than 9 years at onset of diabetes, subjects who were younger than 4 years at onset had an OR of 3.27 (2.20–4.85). CONCLUSIONS— We have provided evidence that 1) the prevalence of biopsy-confirmed celiac disease in children and adolescents with type 1 diabetes is high (6.8%); 2) the risk of having both diseases is threefold higher in children diagnosed with type 1 diabetes at age 4 years than in those age 9 years; and 3) girls have a higher risk of having both diseases than boys

Ultrastructural features of gametogenesis in Branchiura sowerbyi Beddard (Oligochaeta, Tubificidae)

An ultrastructural analysis of the gametogenetic phases in Branchiura sowerbyi, a tubificid oligochaete, has been accomplished. These phases mostly conform to the usual pattern for the family, however, some interesting peculiarities are pointed out. The regression of sexual apparatus after reproductive period and its regeneration up to a new period of sexual maturity, has been followed throughout the yea

On the dynamics of a pair of coupled neurons subject to alternating input rates

We present a statistical analysis of the firing activity of two coupled neuronal units that interact according to a ‘sending–receiving’ model. The membrane potential’s behavior of both units is described by the Stein equations under the additional assumption that the spikes released by the sending neuron constitute an extra excitation for the receiving one. We also assume the presence of an alternating behavior for the rates of inputs to the sending neuron. By means of ad hoc simulations, we obtain, and then discuss, some statistical results concerning the spike production times of the units within the subintervals of the alternating inputs, as well as the reaction times of the receiving neuron

Symptom analysis improves GERD diagnosis and may be helpful to define a successful surgical approach

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Long-term mass-balance monitoring and evolution of ice in caves through structure from motion–multi-view stereo and ground-penetrating radar techniques

This study investigates the application of a terrestrial structure from motionmulti-view stereo (SfM-MVS) approach combinedwith ground-penetrating radar (GPR) surveys formonitoring the surface topographic change of two permanent ice deposits in caves located in the Julian Alps (south-eastern European Alps). This method allows accurate calculation of both seasonal and annual mass balance, estimating the amount of ice inside caves. The ground-based SfM approach represents a low-cost workflow with very limited logistical problems of transportation and human resources and a fast acquisition time, all key factors in such extreme environments. Under optimal conditions, SfM-MVS allows sub-centimetric resolution results, comparable to more expensive and logistically demanding surveys such as terrestrial laser scanning (TLS). Fourteen SfM acquisitions were made between the 2017–2020 ablation seasons (i.e. July–October) while 2 GPR surveys were acquired in 2012. The obtained dense point clouds and digital terrain models (DTMs) made possible a reliable calculation of topographic changes and mass balance rates during the analysed period. The integration of SfM-MVS products with GPR surveys provided comprehensive imaging of the ice thickness and the total ice volume present in each of the caves, proving to be a reliable, low cost and multipurpose methodology ideal for long-term monitoring