Što je novo u radiologiji gastrointestinalnog sustava?

Few subspecialty fields in radiology have undergone so many changes in the last several decades as has gastrointestinal (GI) radiology. We have witnessed the appearance of previously unknown or very uncommon diseases and observed changes in the prevalence and treatment of known diseases. In the clinical setting, abdominal radiology had a seminal role in evaluating these conditions. Scientific and technological advancements, hand-in-hand with clinical practice, have reached previously inconceivable outcomes. From luminal barium examinations gastrointestinal radiology has moved into the realm of cross-sectional imaging and interventional procedures. It now encompasses not only the alimentary canal, but also organs such as the liver, pancreas and spleen. The interest in imaging of intra- and extraperitoneal spaces and organs has grown among GI radiologists.Proteklih desetljeća malo je supspecijalističkih područja radiologije doživjelo toliko promjena kao radiologija gastrointestinalnog sustava. Postali smo svjedoci pojavljivanja dosad nepoznatih ili vrlo rijetkih bolesti te promjena učestalosti i liječenja poznatih bolesti. U kliničkim okvirima abdominalna radiologija imala je ključnu ulogu u procjenjivanju tih stanja. Znanstveni i tehnološki napredak, zajedno s kliničkom praksom, postigli su dosad nezamislive rezultate. Gastrointestinalna radiologija je od pretraživanja lumena barijem prešla u područje prikazivanja poprečnih presjeka i intervencijskih postupaka. Danas ona ne obuhvaća samo probavnu cijev, nego i organe poput jetre, gušterače ili slezene. Me.u radiolozima koji se bave probavnim sustavom sve veće je zanimanje za prikazivanje intraperitonealnih i ekstraperitonealnih prostora i organa. Udruženje gastrointestinalnih radiologa osnovano je sedamdesetih godina prošloga stoljeća. Cilj ovoga udruženja, koje ima 365 članova, objedinjavanje je radioloških spoznaja i metoda u području abdomena, ekstraperitoneuma i zdjelice na edukacijskim skupovima, te razmjena informacija

Što je novo u radiologiji gastrointestinalnog sustava?

Few subspecialty fields in radiology have undergone so many changes in the last several decades as has gastrointestinal (GI) radiology. We have witnessed the appearance of previously unknown or very uncommon diseases and observed changes in the prevalence and treatment of known diseases. In the clinical setting, abdominal radiology had a seminal role in evaluating these conditions. Scientific and technological advancements, hand-in-hand with clinical practice, have reached previously inconceivable outcomes. From luminal barium examinations gastrointestinal radiology has moved into the realm of cross-sectional imaging and interventional procedures. It now encompasses not only the alimentary canal, but also organs such as the liver, pancreas and spleen. The interest in imaging of intra- and extraperitoneal spaces and organs has grown among GI radiologists.Proteklih desetljeća malo je supspecijalističkih područja radiologije doživjelo toliko promjena kao radiologija gastrointestinalnog sustava. Postali smo svjedoci pojavljivanja dosad nepoznatih ili vrlo rijetkih bolesti te promjena učestalosti i liječenja poznatih bolesti. U kliničkim okvirima abdominalna radiologija imala je ključnu ulogu u procjenjivanju tih stanja. Znanstveni i tehnološki napredak, zajedno s kliničkom praksom, postigli su dosad nezamislive rezultate. Gastrointestinalna radiologija je od pretraživanja lumena barijem prešla u područje prikazivanja poprečnih presjeka i intervencijskih postupaka. Danas ona ne obuhvaća samo probavnu cijev, nego i organe poput jetre, gušterače ili slezene. Me.u radiolozima koji se bave probavnim sustavom sve veće je zanimanje za prikazivanje intraperitonealnih i ekstraperitonealnih prostora i organa. Udruženje gastrointestinalnih radiologa osnovano je sedamdesetih godina prošloga stoljeća. Cilj ovoga udruženja, koje ima 365 članova, objedinjavanje je radioloških spoznaja i metoda u području abdomena, ekstraperitoneuma i zdjelice na edukacijskim skupovima, te razmjena informacija

Essays on Credit Markets and on Information

In the first chapter of my thesis, titled “Interventions in Credit Markets and Effects on Economic Activity: Evidence from Brazil,” I investigate the impact of the Brazilian government policy implemented in March 2012, which aimed at increasing credit supply through public banks. Using bank branch level data, I find that the policy successfully increased overall credit supply, as increased lending of public banks did not significantly offset private lending. On the other hand, there is no evidence of significant client-switching between private and public banks. However, the effects of the policy on economic activity were limited and even negligible. I conduct a series of robustness checks to further explore this puzzling result. I find evidence suggesting that increased lending led to significant increases in deposits, indicating that borrowers leveraged easily accessible credit to take loans and save funds for future use. In the second chapter, titled “Television Introduction and Agricultural Production,” I investigate how improved information affected agricultural activity in the U.S. Specifically, I argue that the introduction of television brings more comprehensible weather forecast information to farmers, improving their decision making process. Using data about television entry and county level farming production in a difference-in-differences methodology, I estimate economically significant effect of television introduction on crop yields

Pricing American options - aspects of computation

An American option is a type of option that can be exercised at any time up to its expiration. American options are generally hard to value, as there is no closed-form solution for the price of an American option. When there are multiple stochastic factors in the equation, the usual solution methods – binomial trees and finite difference approaches – become infeasible. Therefore, only estimators based on Monte Carlo simulation can provide good quality results. The Least-square Monte Carlo method (LSM) is the most widely used Monte Carlo-based algorithm in the financial industry. In this thesis, the LSM algorithm and associated literature are reviewed and analysed. The first major contribution is the identification of the basic powers polynomial of 4th order as the most efficient basis polynomial for the least-squares regression within the LSM simulation. The conclusion is also drawn that the performance of LSM depends on both the number of time-steps and the number of simulated paths. Another significant finding in this thesis is that, for every option being valued with a predetermined number of paths, an 'optimal' number of time-steps exists for which the estimator's mean is closest to the exact value of the option. It is proved that, in the case of the LSM algorithm, the general belief that Monte Carlo simulations become more and more efficient with the increase in the number of iterations within the simulation does not necessarily hold. The proposed Average of Batch of LSM Estimates (ABO-LSME) approach calculates the average of multiple optimal LSM estimates within the same or less time than needed for the original LSM estimate and, surprisingly, yields more precise results than the original LSM approach. The basis of the newly introduced Bundled LSM (BLSM) algorithm is an LSM algorithm in which all of the in-the-money paths at each time-step are sorted (similar to Tilley's bundling algorithm, except only in-the-money paths are sorted) and divided into a predetermined number of bundles, to which separate least-squares regressions are applied. This method provides much more stable and precise results than the original LSM algorithm. When optimal BLSM is compared to the optimal LSM algorithm, the superiority of the BLSM estimator becomes clear. BLSM provides results with lower relative errors and RMSEs, around two times faster than optimal LSM

Statistical Methods Useful in Clinical Simulation and Medical Education Scholarship

The objective of this paper is to introduce selected statistical and epidemiologic topics that are of interest to interdisciplinary teams of healthcare quality professionals, educators, technical staff, and researchers who participate in clinical simulation scholarship. Four research vignettes in the setting of a hypothetical clinical simulation training workshop are presented. The first vignette illustrates the utility of exact logistic regression when analyzing a small dataset. The second underscores the importance of using an appropriate method to account for the repeated measurement of an outcome. The third illustrates the use of the intraclass correlation coefficient to measure inter-rater reliability. The final vignette demonstrates the benefits of creating a causal diagram known as a directed acyclic graph

Efeitos da reabilitação precoce no desfecho da reabilitação pós-acidente vascular encefálico (AVE) em mulheres com mais de 65 anos e sua correlação com a gravidade do deficit neurológico inicial

Este trabalho visa examinar os efeitos da reabilitação precoce, a curto e longo prazo, no desfecho do acidente vascular encefálico (AVE) em mulheres com mais de 65 anos; estabelecer a correlação entre o impacto da gravidade do déficit neurológico na predição dos re-sultados do tratamento de Reabilitação e, ainda, investigar a possibilidade do acompanhamento de parâmetros individuais da Medição de Independência Funcional (MIF) na predição do desfecho da reabilitação do AVE. Atualmente, o AVE é a terceira maior causa de mortalidade na população mundial, bem como a maior causa de invalidez permanente. No cenário atual, as doenças cardiovasculares e cerebrovasculares - que antes eram tidas como exclusivas da população masculina – têm afetado também as mulheres. Por outro lado, observamos uma correlação linear entre o envelhecimento e a ocorrência destas doenças. Concluímos que a implantação do método de reabilitação precoce conduz a uma aceleração significativa do processo de tratamento e recuperação após o AVE em mulheres com mais de 65 anos. Concluímos também que certos parâmetros da MIF, por apresentarem o mesmo padrão de evolução, podem ser utilizados na predição da recuperação global do paciente.This study aims at verifying the effects of short- and long-term rehabilitation on the outcome of encephalic vascular accident (EVA) in women older than 65 years; establishing the correlation between the impact of the neurological deficit severity on the prediction of the rehabilitation treatment outcome as well as investigating the possibility of the follow-up of individual parameters at the Functional Independence Measure (FIM) when predicting the EVA rehabilitation outcome. The EVA is currently the third major cause of death in the world’s population, as well as the main cause of permanent disability. In the present scenario, cardiovascular and cerebrovascular diseases, which used to be observed almost exclusively in the male population, now affect the female population as well. On the other hand, we observe a linear correlation between aging and the occurrence of these diseases. We conclude that the implementation of early rehabilitation leads to a significant acceleration in the treatment and recovery process post-EVA in women older than 65 years. We also conclude that certain FIM parameters can be used to predict the patient’s overall recovery, as they present the same evolution pattern

Physical Inactivation of SARS-CoV-2 and Other Coronaviruses: A Review

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus responsible for the ongoing pandemic of Coronavirus Disease 2019 (COVID-19). Other members of the enveloped RNA virus family Coronaviridae have been responsible for a variety of human diseases and economically important animal diseases. Disinfection of air, environmental surfaces, and solutions is part of infection prevention and control (IPAC) for such viruses and their associated diseases. This article reviews the literature on physical inactivation (disinfection) approaches for SARS-CoV-2 and other coronaviruses. Data for thermal (heat) inactivation, gamma irradiation, and ultraviolet light in the C range (UVC) irradiation have been reviewed. As expected, the susceptibilities of different members of the Coronaviridae to these physical inactivation approaches are similar. This implies that knowledge gained for SARS-CoV-2 should be applicable also to its emerging mutational variants and to other future emerging coronaviruses. The information is applicable to a variety of disinfection applications, including IPAC, inactivation of live virus for vaccine or laboratory analytical use, and waste stream disinfection

Efeito da estimulação elétrica nervosa transcutânea (TENS) no tratamento de dor pós-cirúrgica após amputação de membro inferior: estudo piloto

Transcutaneous electrical nerve stimulation (TENS) is a noninvasive, nonmedical modality.  Objective: To establish the role of TENS for the management of postoperative surgical pain after lower limb amputations. Methods: Randomized controlled trial, which included forty-six subjects who had undergone lower limb amputations, randomly divided into control and treatment group. The control group received standard postoperative care, whereas the treatment group received standard postoperative care plus TENS. Forty subjects successfully completed the study according to the study protocol. The majority of the individuals had undergone transtibial amputation due to complication of diabetes. Five TENS XL-A1 portable devices with four self-adhesive electrodes were used. This was the conventional TENS mode, characterized by the delivery of electrical impulses with a duration of 200 microseconds, frequency of 110 Hz, and amplitude of 44V. Treatment was carried out for 2 hours a day, during 10 days. The evaluation of TENS efficacy was performed using the horizontal VAS (0-100 mm). Student T test was used in the statistical analysis. Results: Pain intensity was significantly diminished in both groups at the tenth in comparison with the first postoperative day. Conclusion: Conventional TENS (dose: 200 microseconds, 110 Hz, 44V), administered two hours a day during ten days, significantly reduced postoperative surgical pain in twenty subjects who had undergone lower limb amputations.A estimulação elétrica nervosa transcutânea (TENS) é uma modalidade não médica e não invasiva. Objetivo: Avaliar o papel da TENS no tratamento de dor cirúrgica pós-operatória após amputação de membro inferior. Métodos: Teste controlado randomizado, conduzido com 46 indivíduos submetidos à amputação de membro inferior, que foram aleatoriamente divididos em grupo controle e grupo tratado. O grupo controle recebeu cuidados-padrão no pós-operatório; o grupo tratado recebeu cuidados-padrão e aplicação de TENS. Quarenta indivíduos completaram efetivamente o estudo de acordo com o protocolo de estudo. A maior parte das amputações consistiu de amputação transtibial devido a complicações da diabete. Foram utilizados cinco dispositivos portáteis Ultima TENS XL-A1 com eletrodos auto-adesivos. Esta é a aplicação convencional da TENS, caracterizada pela aplicação de impulsos elétricos com a duração de 200 microssegundos, freqüência de 110 Hz e amplitude de 44 V. O tratamento foi administrado durante 10 dias, 2 horas por dia. A avaliação da eficácia da TENS foi feita utilizando-se a escala visual analógica (EVA) horizontal (0-100 mm). O teste t de Student foi usado na análise estatística. Resultados: A intensidade da dor estava significantemente diminuída em ambos os grupos no 10º dia em comparação ao 1º dia de pós-operatório.  Conclusão: A TENS convencional (dose: 200 microssegundos, 110 Hz, 44 V), administrada 2 horas por dia, durante 10 dias, significantemente reduziu a dor cirúrgica pós-operatória em 20 indivíduos com amputação de membro inferior

Clinical effects of acupuncture and periarticular local infiltration of corticosteroids in the treatment of gonarthrosis

Gonarthrosis is one of the most frequently degenerative diseases. Pain, derange of function and= deformation of joint are dominating clinical signs. Aim of the study: To compare clinical effect obtained with three different therapeutic models: 1. Acupuncture; 2. Local infiltration of corticosteroid; 3. Combination of acupuncture and local infiltration of corticosteroid. Material and methods: An open, prospective, randomized clinical study included 21 female patients in acute phase of gonarthrosis. Diagnosis was made by clinical and radiographic examinations. Patients were divided into three groups: I group: 7 patients, average age 61.0 ± 6.8 years, treated with needle acupuncture (points: Du.20, Ex.31, Ex.32, St.35, UB.40, St.44, UB.60, Li.4, Sp.9,UB.11), 10 treatments. II group: 7 patients, average age 59.0 ± 10.1 years, treated with infiltration of Bethametasonum – Diprophos on the first day of treatment with frontal approach on the medial or the lateral side of m. quadriceps tendon. III group: 7 patients, average age 58 ± 6.07 years, treated with a combination of initial infiltration of Bethametasonum – Diprophos and needle acupuncture, 10 treatments. The evaluation of efficacy parameters were performed by following parameters: 1. Subjective difficulties – pain (VAS 0-100 mm); 2. Sizeof knee, measured across the middle of patella with centimeter band; 3. Range of joint motion (flexion), measured using a goniometer. All of these parameters were measured on 1st, 8th and 21st day of treatment. One way ANOVA, repeated measures ANOVA and post hoc tests were applied for statistic analysis. Results: 1. There were high significant improvements in the parameters of pain intensity and size of knee inside the groups; One way ANOVA test, p=0.000<0.01; 2. There were no significant improvements in the parameter of joint movement inside the groups; One way ANOVA test, p=0.528>0.05; 3. There were high significant improvements in all parameters (pain intensity, size of knee, joint movement) in all three groups; Repeated measures ANOVA test, p=0.000<0.01. Conclusion: Combined treatment of acupuncture and local infiltration of a corticosteroid has better effectiveness in pain intensity, size of knee and improvement of motion in comparison with monotherapy.Gonartrose é uma das doenças degenerativas mais comuns. Dor, deficiência e deformidade articular são os sinais clínicos dominantes. Objetivo do estudo: Comparar o efeito clínico obtido com três diferentesmodelos terapêuticos: 1. Acupuntura; 2. Infiltração local de corticosteróide; 3. Combinação de acupuntura e infiltração local de corticosteróide. Material e Métodos: Um estudo clínico prospectivo, aleatorizado, aberto incluiu 21 pacientes do sexo feminino em fase aguda de gonartrose. O diagnóstico foi feito através de exames clínicos e radiográficos. As pacientes foram divididas em três grupos: Grupo I: 7 pacientes com média de idade de 61,0 ± 6,8 anos, tratadas através de acupuntura com agulhas (pontas: Du20, Ex31, Ex32, St35, UB40, St44, UB60, Li4, Sp9,UB11), 10 tratamentos. Grupo II: 7 pacientes com 59,0 ± 10,1 anos, tratadas com infiltração de Betametasona – Diprofos, no primeiro dia de tratamento com abordagem frontal na parte lateral ou medial do tendão do músculo quadríceps. Grupo III: 7 pacientes, com 58,0 ± 6,07 anos, tratadas com uma combinação de infiltração inicial de Betametasona – Diprofos e acupuntura com agulhas, 10 tratamentos. A avaliação dos parâmetros de eficácia foi feita através dos seguintes parâmetros: 1. Dificuldades subjetivas – dor (Escala visual analógica – EVA de 0 a 100 mm); 2. tamanho do joelho, medido através do meio da patela em centímetros; 3. Amplitude de movimento articular (flexão), medida com um goniômetro. Todos esses parâmetros foram medidos no 1º, 8º e 21º dia de tratamento. ANOVA unifatorial, ANOVA de medida repetida e testes post hoc foram utilizados na análise estatística. Resultados: 1. Houve significativa melhora nos parâmetros de intensidade de dor e tamanho do joelho dentro dos grupos; ANOVA unifatorial,  p<0,01; 2. Não houve melhora significativa no parâmetro de movimento articular dentro dos grupos; ANOVA unifatorial, p=0,528; 3. Houve melhoras significativas em todos os parâmetros (intensidade da dor, tamanho do joelho, movimento articular) nos três grupos; ANOVA de medida repetida, p<0,01. Conclusão: O tratamento combinado de acupuntura e infiltração de corticosteróide tem melhor efetividade em intensidade da dor, tamanho do joelho e melhora do movimento articular em comparação com a monoterapia