A bizarre foreign body in the appendix: A case report

Foreign bodies are rare causes of appendicitis and, in most cases, ingested foreign bodies pass through the alimentary tract asymptomatically. However, ingested foreign bodies may sometimes remain silent within the appendix for many years without an inflammatory response. Despite the fact that cases of foreign-body-induced appendicitis have been documented, sharp and pointed objects are more likely to cause perforations and abscesses, and present more rapidly after ingestion. Various materials, such as needles and drill bits, as well as organic matter, such as seeds, have been implicated as causes of acute appendicitis. Clinical presentation can vary from hours to years. Blunt foreign bodies are more likely to remain dormant for longer periods and cause appendicitis through obstruction of the appendiceal lumen. We herein describe a patient presenting with a foreign body in his appendix which had been swallowed 15 years previously. The contrast between the large size of the foreign body, the long clinical history without symptoms and the total absence of any histological inflammation was notable. We suggest that an elective laparoscopic appendectomy should be offered to such patients as a possible management optio

MRI analysis for Hippocampus segmentation on a distributed infrastructure

Medical image computing raises new challenges due to the scale and the complexity of the required analyses. Medical image databases are currently available to supply clinical diagnosis. For instance, it is possible to provide diagnostic information based on an imaging biomarker comparing a single case to the reference group (controls or patients with disease). At the same time many sophisticated and computationally intensive algorithms have been implemented to extract useful information from medical images. Many applications would take great advantage by using scientific workflow technology due to its design, rapid implementation and reuse. However this technology requires a distributed computing infrastructure (such as Grid or Cloud) to be executed efficiently. One of the most used workflow manager for medical image processing is the LONI pipeline (LP), a graphical workbench developed by the Laboratory of Neuro Imaging (http://pipeline.loni.usc.edu). In this article we present a general approach to submit and monitor workflows on distributed infrastructures using LONI Pipeline, including European Grid Infrastructure (EGI) and Torque-based batch farm. In this paper we implemented a complete segmentation pipeline in brain magnetic resonance imaging (MRI). It requires time-consuming and data-intensive processing and for which reducing the computing time is crucial to meet clinical practice constraints. The developed approach is based on web services and can be used for any medical imaging application

Trend following, risk parity and momentum in commodity futures

We show that combining momentum and trend following strategies for individual commodity futures can lead to portfolios which offer attractive risk adjusted returns which are superior to simple momentum strategies; when we expose these returns to a wide array of sources of systematic risk we find that robust alpha survives. Experimenting with risk parity portfolio weightings has limited impact on our results though in particular is beneficial to long–short strategies; the marginal impact of applying trend following methods far outweighs momentum and risk parity adjustments in terms of risk-adjusted returns and limiting downside risk. Overall this leads to an attractive strategy for investing in commodity futures and emphasises the importance of trend following as an investment strategy in the commodity futures context

Characterization of a K+-induced conformational switch in a human telomeric DNA oligonucleotide using 2-aminopurine fluorescence

Human telomeric DNA consists of tandem repeats of the DNA sequence d(GGGTTA). Oligodeoxynucletotide telomere models such as d[A(GGGTTA)(3)GGG] (Tel22) fold in a cation-dependent manner into quadruplex structures consisting of stacked G-quartets linked by d(TTA) loops. NMR has shown that in Na(+) solutions Tel22 forms a ‘basket’ topology of four antiparallel strands; in contrast, Tel22 in K(+) solutions consists of a mixture of unknown topologies. Our previous studies on the mechanism of folding of Tel22 and similar telomere analogs utilized changes in UV absorption between 270 and 325 nm that report primarily on G-quartet formation and stacking showed that quadruplex formation occurs within milliseconds upon mixing with an appropriate cation. In the current study, we assessed the dynamics and equilibria of folding of specific loops by using Tel22 derivatives in which the dA residues were serially substituted with the fluorescent reporter base, 2-aminopurine (2-AP). Tel22 folding induced by Na(+) or K(+) assessed by changes in 2-AP fluorescence consists of at least three kinetic steps with time constants spanning a range of ms to several hundred seconds. Na(+)-dependent equilibrium titrations of Tel22 folding could be approximated as a cooperative two-state process. In contrast, K(+)-dependent folding curves were biphasic, revealing that different conformational ensembles are present in 1 mM and 30 mM K(+). This conclusion was confirmed by (1)H NMR. Molecular dynamics simulations revealed a K(+) binding pocket in Tel22 located near dA1 that is specific for the so-called hybrid-1 conformation in which strand 1 is in a parallel arrangement. The possible presence of this topologically specific binding site suggests that K(+) may play an allosteric role in regulating telomere conformation and function by modulating quadruplex tertiary structure

Benign blockage: gastric outlet obstruction due to a prolapsing gastric pedunculated polyp. Case report and literature review

NO ABSTRACT AVAILABLEAn 89-year-old woman was admitted to the emergency department at “Ospedale Civile Umberto I” in Lugo (Ravenna) for 1 month of vomiting, mild epigastric pain, and postprandial diarrhea without fever. Main comorbidities included chronic atrial fbrillation treated with a direct-acting oral anticoagulant, previous MI, hypertension, diabetes, and hypercholesterolemia, though despite her age the patient was autonomous in her daily activities. On admission, laboratory tests included normal WBC count, Hgb, and CRP. Abdominal X-ray demonstrated a stomach flled by ingested food (Fig. 1a) and difuse air–fuid levels accompanied by abdominal distension (Fig. 1b). A surgical consultation was requested; a CT scan was performed confrming gastric distension by ingested food (Fig. 2). Since gastric outlet obstruction was suspected, the patient was hospitalized in a medical unit, treated with NPO and IV fuids. After 2 weeks, a second surgical consultation was requested due to the recurrence of clinical symptoms with unchanged laboratory tests. An upper GI series reported normal gastric and duodenal transit (Fig. 3) while colonoscopy was negative. The patient underwent EGD that showed a 4-cm pedunculated polyp situated in the gastric antrum; the polyp prolapsed into the duodenal bulb creating a “ball valve”-type intermittent obstruction. Biopsy was consistent with a hyperplastic polyp which was endoscopically resected (Fig. 4a–c). The fnal histological report confrmed a benign lesion; the patient was discharged from the hospital without any further invasive treatment in good general condition

Dynamic configuration and data security for bioinformatics cloud services with the Laniakea Dashboard

Technological advances in high-throughput technologies improve our ability to explore the molecular mechanisms of life. Computational infrastructures for scientific applications fulfil a critical role in harnessing this potential. However, there is an ongoing need to improve accessibility and implement robust data security technologies to allow the processing of sensitive data, particularly human genetic data. Scientific clouds have emerged as a promising solution to meet these needs. We present three components of the Laniakea software stack, initially developed to support the provision of private on-demand Galaxy instances. These components can be adopted by providers of scientific cloud services built on the INDIGO PaaS layer. The Dashboard translates configuration template files into user-friendly web interfaces, enabling the easy configuration and launch of on-demand applications. The secret management and the encryption components, integrated within the Dashboard, support the secure handling of passphrases and credentials and the deployment of block-level encrypted storage volumes for managing sensitive data in the cloud environment. By adopting these software components, scientific cloud providers can develop convenient, secure and efficient on-demand services for their users

Measurements of radioactivity in the environment for radiation protection purposes

Measurements of radioactivity in the environment, according to Article 35 of the Euratom Treaty, are routinely carried out by regulatory bodies and operators in charge. These activities are performed both locally and nationally, in order to assess effective doses to the population. In this context, therefore, it is necessary not only to determine the component due to external irradiation, but also to evaluate the deposit and accumulation of radioactivity in the environment that can reach the public via inhalation or ingestion. The contribution presents a brief description of the aspects regarding programs of monitoring and evaluation of the radioactivity in the environment, in particular the environmental matrices to be monitored, the analyses to be carried out, the related reporting levels as well as the features concerning the influence of the climate on the variations of dose rate values. Finally, a focus on some radiometric measurements performed over the last forty years in the environmental monitoring activities carried out in the ENEA Casaccia Research Center (Rome), in which two nuclear research facilities are currently operating, is presented

Multicenter Observational/Exploratory Study Addressed to the Evaluation of the Effectiveness and Safety of Pharmacological Therapy in Opioid-Dependent Patients in Maintenance Therapy in Southern Italy

A multicenter-observational study was performed to assess the effectiveness of rac-methadone, levomethadone, and buprenorphine in opioid-dependent patients in polytherapy in Southern Italy. The primary endpoint was the reduction of urinary positivity to the substances and the maintaining doses. Patients (N = 266, age = 44.80 ± 5.65, male = 79.70%, female = 20.30%) have been recruited. At recruitment, 75% of them were on treatment with rac-methadone, levomethadone, and buprenorphine/naloxone. The patients were grouped into three clusters. The levomethadone patients of Cluster A (N patients = 211), after 180 days, showed stability in urinary methadone posi-tivity, with a marked decrease in heroin −53 ± 4%, cannabinol’s −48 ± 2%, and cocaine −37 ± 6% positivity, with no differences between treatments. A lower QTcF value of 426 ± 8.4 ms was recorded in the levomethadone patients (delta = −19 ms) vs. rac-methadone, at significantly lower doses of levomethadone (−34%, −50.2% in males) (p < 0.05). The Cluster B data were collected from 37 patients, with a high prevalence of comorbidity infections (HIV/HCV/HPV), monitored for 21 months during COVID-19. High doses of levomethadone (58.33 ± 31.58 mg/day) were needed to stabilize those that were negative for opioids and cannabinoids, in contrast to the rac-methadone and buprenorphine/naloxone patients that showed positive toxicology. Eighteen patients of the Cluster C in double diagnosis (major depressive 38.90%, bipolar 27.78%, and schizophrenia 16.67%) were stabilized with high doses of racemate 97.5 ± 8 mg/day, 51.8 ± 5 mg/day of levomethadone (−46.8% vs. rac-methadone; −71% in men), and 2.5 ± 1 mg/day of buprenorphine/naloxone. Three patients in remission were treated with tapering doses of levomethadone. Significantly reduced QTcF values were recorded with levomethadone (delta −32 ms vs. rac-methadone) in the bipolar patients, as well as the schizophrenia patients in remission (delta −45.19 ms vs. rac-methadone). Our patients were safely stabilized. Levomethadone, compared to the racemate, contributes to reducing the illicit use, especially of opioids and cannabinoids at significantly lower doses with cardiovascular safety, which, in bipolar patients, is clinically significant

Copy Number Variation Analysis in Single-Suture Craniosynostosis: Multiple Rare Variants Including RUNX2 Duplication in Two Cousins With Metopic Craniosynostosis

Little is known about genes that underlie isolated single-suture craniosynostosis. In this study, we hypothesize that rare copy number variants (CNV) in patients with isolated single-suture craniosynostosis contain genes important for cranial development. Using whole genome array comparative genomic hybridization (CGH), we evaluated DNA from 186 individuals with single-suture craniosynostosis for submicroscopic deletions and duplications. We identified a 1.1 Mb duplication encompassing RUNX2 in two affected cousins with metopic synostosis and hypodontia. Given that RUNX2 is required as a master switch for osteoblast differentiation and interacts with TWIST I, mutations in which also cause craniosynostosis, we conclude that the duplication in this family is pathogenic, albeit with reduced penetrance. In addition, we find that a total of 7.5% of individuals with single-suture synostosis in our series have at least one rare deletion or duplication that contains genes and that has not been previously reported in unaffected individuals. The genes within and disrupted by CNVs in this cohort are potential novel candidate genes for craniosynostosis. (C) 2010 Wiley-Liss, Inc