Association between diverticulosis and colonic neoplastic lesions in individuals with a positive faecal immunochemical test

Background The association between diverticulosis and colonic neoplastic lesions has been suggested, but data in literature are conflicting. This study aimed to investigate such a relationship in patients participating in a colorectal cancer screening program who underwent high-quality colonoscopy.Methods Data from consecutive individuals 50-75 years of age with a positive faecal immunological test were considered. Diverticulosis was categorised as present or absent. The prevalence of neoplastic lesions (adenoma, advanced adenoma, and cancer) between individuals with and those without diverticula was compared. A multivariate analysis was performed.Results Overall, data from 970 consecutive individuals were evaluated, and diverticulosis was detected in 354 (36.5%) cases. At least one adenoma was detected in 490 (50.5%) people, at least one advanced adenoma in 264 (27.2%), multiple adenoma in 71 (7.3%), whilst a cancer was diagnosed in 48 (4.9%) cases. At univariate analysis, the adenoma detection rate in patients with diverticula was significantly higher than in controls (55.9% vs 47.4%; p=0.011). At multivariate analysis, presence of diverticulosis was an independent risk factor for both adenoma detection rate (OR=1.58; 95% CI=1.14-2.18; p=0.006) and advanced adenoma (OR=1.57; 95% CI=1.10-2.24; p=0.013), but not for colorectal cancer.Conclusions In a colorectal screening setting, the adenoma detection rate was significantly higher in individuals with diverticulosis than in controls

High concordance between trained nurses and gastroenterologists in evaluating recordings of small bowel video capsule endoscopy (VCE)

Background & Aims: The video capsule endoscopy (VCE) is an accurate and validated tool to investigate the entire small bowel mucosa, but VCE recordings interpretation by the gastroenterologist is time-consuming. A pre-reading of VCE recordings by an expert nurse could be accurate and cost saving. We assessed the concordance between nurses and gastroenterologists in detecting lesions on VCE examinations. Methods: This was a prospective study enrolling consecutive patients who had undergone VCE in clinical practice. Two trained nurses and two expert gastroenterologists participated in the study. At VCE pre-reading the nurses selected any abnormalities, saved them as “thumbnails” and classified the detected lesions as a vascular abnormality, ulcerative lesion, polyp, tumor mass, and unclassified lesion. Then, the gastroenterologist evaluated and interpreted the selected lesions and, successively, reviewed the entire video for potential missed lesions. The time for VCE evaluation was recorded. Results: A total of 95 VCE procedures performed on consecutive patients (M/F: 47/48; mean age: 63 ± 12 years, range: 27−86 years) were evaluated. Overall, the nurses detected at least one lesion in 54 (56.8%) patients. There was total agreement between nurses and gastroenterologists, no missing lesions being discovered at a second look of the entire VCE recording by the physician. The pre-reading procedure by nurse allowed a time reduction of medical evaluation from 49 (33-69) to 10 (8-16) minutes (difference:-79.6%). Conclusions: Our data suggest that trained nurses can accurately identify and select relevant lesions in thumbnails that subsequently were faster reviewed by the gastroenterologist for a final diagnosis. This could significantly reduce the cost of VCE procedure

Impacto das mudanças climáticas sobre a produção de cana-de-açúcar no Estado de Goiás.

A elevação do preço do petróleo, o apelo mundial pela redução das emissões de gases de efeito estufa e a produção de energia renovável viabilizaram o aumento da produção de álcool e criaram a necessidade de identificação de áreas de expansão do cultivo da cana-de-açúcar no Brasil. Por outro lado, o último relatório do IPCC apresenta informações conclusivas sobre ocorrências de alterações do clima e elevação das temperaturas. Neste sentido, estudos para identificar a vulnerabilidade dos sistemas agrícolas e quantificar o impacto das mudanças climáticas sobre as culturas agrícolas tornaram-se uma necessidade. O objetivo deste trabalho foi simular o efeito das mudanças climáticas sobre a produção de cana-de-açúcar, variedade RB72454, cultivada em três localidades de Goiás, admitindo-se a elevação da temperatura em 1,8°C, 2,4°C e 4,0°C. Os resultados mostraram elevação na produtividade média, mesmo no cenário pessimista (4,0°C), nos municípios de Goiânia e Jataí, em 3% e 4%, respectivamente; enquanto em Goianésia, observou-se uma redução de 6% na produtividade.CBA 2009

Algebraic entropy for algebraic maps

We propose an extension of the concept of algebraic entropy, as introduced by Bellon and Viallet for rational maps, to algebraic maps (or correspondences) of a certain kind. The corresponding entropy is an index of the complexity of the map. The definition inherits the basic properties from the definition of entropy for rational maps. We give an example with positive entropy, as well as two examples taken from the theory of Backlund transformations

Cephalopods Between Science, Art, and Engineering: A Contemporary Synthesis

ABSTRACT Cephalopods are outstanding animals. For centuries, they have provided a rich source of inspiration to many aspects of human cultures, from art, history, media and spiritual beliefs to the most exquisite scientific curiosity. Given their high esthetical value and 'mysteriously' rich behavioral repertoire they have functioned as boundary objects (or subjects) connecting seemingly distinct thematic fields. Interesting aspects of their being span from the rapid camouflaging ability inspiring contemporary art practices, to their soft and fully muscular body that curiously enough inspired both gastronomy and (soft) robotics. The areas influenced by cephalopods include ancient mythology, art, behavioural science, neuroscience, genomics, camouflage technology and bespoken robotics. Although these might seem far related fields, in this manuscript we want to show how the increasing scientific and popular interest in this heterogeneous class of animals have indeed prompted a high level of integration between scientific, artistic and sub-popular culture. We will present an overview of the birth and life of cephalopod investigations from the traditional study of ethology, neuroscience, and biodiversity to the more recent and emerging field of genomics, material industry and soft robotics. Within this framework, we will attempt to capture the current interest and progress in cephalopod scientific research that lately met both the public interest and the 'liberal arts' curiosity

One-year evolution of symptoms and health status of the copd multi-dimensional phenotypes: Results from the follow-up of the storico observational study

Aim: Describing the 1-year evolution of symptoms and health status in COPD patients enrolled in the STORICO study (observational study on characterization of 24-h symptoms in patients with COPD) classified in multidimensional phenotypes (m-phenotypes). Methods: In our previous study, we performed an exploratory factor analysis to identify clinical and pathophysiological variables having the greatest classificatory properties, followed by a cluster analysis to group patients into m-phenotypes (mild COPD (MC), mild emphysematous (ME), severe bronchitic (SB), severe emphysematous (SE), and severe mixed COPD (SMC)). COPD symptoms were recorded at baseline, 6-, and 12-month follow-up and their evolution was described as frequency of patients with always present, always absent, arising’, ‘no more present symptoms. QoL and quality of sleep were evaluated using the SGRQ and CASIS questionnaires, respectively. Results: We analyzed 379 subjects (144 MC, 71 ME, 96 SB, 14 SE, 54 SMC). M-phenotypes were stable over time in terms of presence of symptoms and health status with selected differences in evolution of symptoms in mild vs severe m-phenotypes. Indeed, 28.1% SB, 50.0% SE and 24.1% SMC vs 0.7% MC and 5.6% ME with night-time symptoms at baseline had no more symptoms at 6-month (p-value night-time symptom evolution MC vs SB, SE, SMC and ME vs SB, SE, SMC <0.0001). All m-phenotypes improved in quality of sleep, more markedly the severe than the mild ones (p-values CASIS score change between baseline and 6-or 12-month in MC, ME vs SB, SE, SMC <0.0001). QoL did not change during observation, irrespectively of m-phenotype. Conclusion: Over 1 year, severe m-phenotypes showed an improvement in night-time symptoms and quality of sleep, but not QoL. Being stable over time, m-phenotypes seem worthy of testing for classificatory and prognostic purposes

Prophylactic salpingectomy in premenopausal low-risk women for ovarian cancer: Primum non nocere

Abstract Objective The objective of this study is to compare ovarian function and surgical outcomes between patients affected by benign uterine pathologies submitted to total laparoscopic hysterectomy (TLH) plus salpingectomy and women in which standard TLH with adnexal preservation was performed. Methods We retrospectively compared data of 79 patients who underwent TLH plus bilateral salpingectomy (group A), with those of 79 women treated by standard TLH without adnexectomy (sTLH) (group B). Ovarian reserve modification, expressed as the difference between 3months post-operative and pre-operative values of Anti-Mullerian Hormone (AMH), Follicle Stimulating Hormone (FSH), Antral Follicle Count (AFC), mean ovarian diameters and Peak Systolic Velocity (PSV), was recorded for each patient. For each surgical procedure, operative time, variation of hemoglobin level (ΔHb), postoperative hospital stay, postoperative return to normal activity, and complication rate were recorded as secondary outcomes. Results According to our post-hoc analysis , this equivalence study resulted to have a statistical power of 96.8%. Significant difference was not observed between groups with respect to ΔAMH ( p = 0.35 ), ΔFSH ( p = 0.15 ), ΔAFC ( p = 0.09 ), Δ mean ovarian diameters ( p = 0.57 ) and ΔPSV ( p = 0.61 ). In addition, secondary outcomes such as operative time ( p = 0.79 ), ΔHb ( p = 0.41 ), postoperative hospital stay ( p = 0.16 ), postoperative return to normal activity ( p = 0.11 ) and complication rate also did not show any significant difference. Conclusions The addition of bilateral salpingectomy to TLH for prevention of ovarian cancer in women who do not carry a BRCA1/2 mutations do not show negative effects on the ovarian function. In addition, no perioperative complications are related to the salpingectomy step in TLH