Marine geomagnetic high definition metrology; possible archaeological applications

The marine geomagnetism is often used to solve geological problems at a regional scale: structural, volcanological or mining problems, for instance (Faggioni et al., 1995). In recent time, the development of the “high definition (HD) metrology” (Faggioni et al., 2001) has made the marine geomagnetic method suitable for detecting short wavelength and low amplitude geomagnetic anomalies. This type of signal may be often related to environmental and/or archaeological sources......

Feasibility trial of the newly introduced optical enhancement technology in patients with gastroesophageal reflux disease

BACKGROUND: Optical Enhancement technology (OE) combines bandwidth-limited light and image enhancement processing technology to enhance subtle mucosal and vascular details. This is the first study assessing the new technology for the diagnosis of gastroesophageal reflux disease (GERD). PATIENTS AND METHODS: Consecutive patients with GERD and controls were prospectively included. The distal esophagus was examined in all quadrants with high definition white-light endoscopy (HD-WLE) followed by OE and biopsies for histopathological analysis. Features observed only by OE were compared between controls and patients with GERD. RESULTS: A total of 100 areas were evaluated. About 56% of patients had a diagnosis of GERD. The mean age of patients was 53 years (range 27-89 years), 60% were female. Compared to controls, patients with diagnosis of GERD showed significantly more often tortuosity (p = 0.042), dilation (p = 0.0003), and increased number (p = 0.001) of intrapapillary capillary loops (IPCLs). In addition, increased vascularity and mucosal breaks were significantly more often found in patients with GERD as compared to controls (p < 0.05). On multivariate analysis, increased number and dilation of IPCL were the best predictors of GERD. CONCLUSIONS: The newly introduced OE technology significantly improves the diagnosis of GERD compared to HD-WLE. The results should be confirmed in a multicenter trial

High-resolution marine magnetic surveys for searching underwater cultural resources

Recently two marine magnetic surveys, combined with the use of a multi-beam sonar (Kongsberg Marittime EM 300 multibeam: 30 KHz frequency echosounder for hydrographic purposes; acoustic lobe composed of 128 beams able to cover a 150° sector) a side-scan sonar (Simrad MS 992 dual-frequency sidescan sonar with echo sounder transducers 150 Hz and 330 KHz) and a Remote Operated Vehicle (ROV – a mobile tools used in environments which are too dangerous for humans), were executed in two sites respectively in the Ligurian Sea and the Asinara Gulf. The aim of these investigations was to test modern instrumentations and set new working procedures for searching underwater cultural resources. The collected and processed magnetic data yielded very satisfactory results: we detected submerged and buried features of cultural interest at both sites, at depths of 40 m and 400 m respectively

Ex vivo experimental study on the Thulium laser system : new horizons for interventional endoscopy (with videos)

BACKGROUND AND STUDY AIMS: The Thulium laser system (TLS) is an emerging interventional tool adopted in many surgical specialties. Its 2.0-\u3bcm wavelength allows precise coagulation (0.2\u200a-\u200a0.4\u200amm in depth) and cutting, limiting the possibilities of collateral injuries. We tested the impact of the TLS for gastric endoscopic submucosal dissection (ESD) and per oral endoscopic myotomy (POEM) ex vivo in pigs. MATERIALS AND METHODS: Ex vivo porcine stomach and esophagus models underwent 2 POEMs, and 3 ESDs (mean diameter 3.5\u200acm) with TLS using a 272-\ub5m and a 365-\ub5m thick optical fibers. Both continuous and pulsed laser emission were evaluated. Subsequent histopathological analysis was performed by an expert GI pathologist on the whole porcine models. RESULTS: Complete POEMs and gastric ESDs were successfully performed in all cases in 30 to 70 and 15 to 20 minutes. Both optical fibers were equally effective and precise. The best power output for mucosal incision was 25 to 30\u200aW during ESD and 25\u200aW for POEM using continuous laser emission. During submucosal dissection and tunneling the favorite power output was 20\u200aW and 15 to 20\u200aW, respectively, operating in continuous mode. No transmural perforation occurred throughout the operations and histopathology confirmed the absence of accidental muscular layer damage. CONCLUSIONS: The TLS stands out as a precise and manageable instrument in ex vivo models. This technique appears to be a promising tool for advanced interventional endoscopy

High-definition endoscopy with digital chromoendoscopy for histologic prediction of distal colorectal polyps

Background: Distal diminutive colorectal polyps are common and accurate endoscopic prediction of hyperplastic or adenomatous polyp histology could reduce procedural time, costs and potential risks associated with the resection. Within this study we assessed whether digital chromoendoscopy can accurately predict the histology of distal diminutive colorectal polyps according to the ASGE PIVI statement. Methods: In this prospective cohort study, 224 consecutive patients undergoing screening or surveillance colonoscopy were included. Real time histology of 121 diminutive distal colorectal polyps was evaluated using high-definition endoscopy with digital chromoendoscopy and the accuracy of predicting histology with digital chromoendoscopy was assessed. Results: The overall accuracy of digital chromoendoscopy for prediction of adenomatous polyp histology was 90.1 %. Sensitivity, specificity, positive and negative predictive values were 93.3, 88.7, 88.7, and 93.2 %, respectively. In high-confidence predictions, the accuracy increased to 96.3 % while sensitivity, specificity, positive and negative predictive values were calculated as 98.1, 94.4, 94.5, and 98.1 %, respectively. Surveillance intervals with digital chromoendoscopy were correctly predicted with >90 % accuracy. Conclusions: High-definition endoscopy in combination with digital chromoendoscopy allowed real-time in vivo prediction of distal colorectal polyp histology and is accurate enough to leave distal colorectal polyps in place without resection or to resect and discard them without pathologic assessment. This approach has the potential to reduce costs and risks associated with the redundant removal of diminutive colorectal polyps

MMX® technology and its applications in gastrointestinal diseases

The Multimatrix\uae (MMX\uae) preparation MMX\uae is a recently obtained drug formulation developed to facilitate release of high concentrations of active drugs into the colon, with a homogeneous distribution along all colonic segments, particularly the most distal ones; the distal colonic tracts, indeed, are the most difficult to reach in significant amounts when a drug is given orally. The MMX\uae formulation is characterized by a lipophilic matrix dispersed in a hydrophilic structure. Indeed, in the last few years, MMX\uae technology has been widely used in the development of various drugs for the treatment of inflammatory and infectious gastrointestinal diseases localized in the colon. In particular, MMX\uae mesalamine, budesonide and parnaparin formulations have been investigated in patients with ulcerative colitis, and the first two have reached worldwide registration for the treatment of this disease. Moreover, MMX\uae-rifamycin is being positively tested in the treatment of colonic bacterial infections, including traveler's diarrhea. MMX\uae technology is, thus, proving to be a very effective formulation for the treatment of various colonic diseases. This effectiveness has been related not only to specific colonic delivery, but also to its ability to act in a once-daily dosage, thus favouring patients' adherence to prescribed schedules of treatment. The effective delivery of the active molecule to the site of need in the colon is also associated with very low systemic absorption and very low rates of adverse events (AEs). In this paper, we have reviewed all clinical trials performed with an MMX\uc2\uae-bound drug and all possible real-life reports, in order to give an overall evaluation of MMX\uae

Some magnetic evidences of the Ist century BC Salapia harbor near the Margherita di Savoia shoreline, SE Italy

This paper highlights some magnetic evidences revealed by a recent marine magnetic survey ran near the Margherita di Savoia shoreline, Puglia (Italy). The survey has been planned to probe one of the expected settlement site not perused yet. The accurate elaboration of high density total magnetic field intensity data shows some features which can be interpreted as markers of harbor framework, at present time partially uprooted. A model of the bodies which cause the magnetic anomaly is also provided

Panenteric capsule endoscopy identifies proximal small bowel disease guiding upstaging and treatment intensification in Crohn’s disease: A European multicentre observational cohort study

Background: Endoscopically defined mucosal healing in Crohn\u2019s disease is associated with improved outcomes. Panenteric capsule endoscopy enables a single non-invasive assessment of small and large bowel mucosal inflammation. Aims and methods: This multicentre observational study of patients with suspected and established Crohn\u2019s disease examined the feasibility, safety and impact on patient outcomes of panenteric capsule endoscopy in routine clinical practice. The potential role in assessment of disease severity and extent by a comparison with existing clinical and biochemical markers is examined. Results: Panenteric capsule endoscopy was performed on 93 patients (71 with established and 22 with suspected Crohn\u2019s disease). A complete examination occurred in 85% (79/93). Two cases (2.8%) of capsule retention occurred in patients with established Crohn\u2019s disease. Panenteric capsule resulted in management change in 38.7% (36/93) patients, including 64.6% (32/48) of those with an established diagnosis whose disease was active, and all three patients with newly diagnosed Crohn\u2019s disease. Montreal classification was upstaged in 33.8% of patients with established Crohn\u2019s disease and mucosal healing was demonstrated in 15.5%. Proximal small bowel disease upstaged disease in 12.7% and predicted escalation of therapy (odds ratio 40.3, 95% confidence interval 3.6\u2013450.2). Raised C-reactive protein and faecal calprotectin were poorly sensitive in detecting active disease (0.48 and 0.59 respectively). Conclusions: Panenteric capsule endoscopy was feasible in routine practice and the ability to detect proximal small bowel disease may allow better estimation of prognosis and guide treatment intensification. Panenteric capsule endoscopy may be a suitable non-invasive endoscopic investigation in determining disease activity and supporting management decisions