Benign biliary diseases Bali, M.A; Pezzullo, Martina; Pace, Erika ...
European journal of radiology,
08/2017, Letnik:
93
Journal Article
Recenzirano
Highlights • The clinical and laboratory findings are to be considered in the diagnostic work up of biliary diseases. • Imaging has a key role in the diagnosis of benign biliary diseases. • The ...imaging modality of choice to assess biliary diseases is MR, which allows morphologic and functional assessment.
Umbrella review is one of the terms used to describe an overview of systematic reviews. During the last years, a rapid increase in the number of umbrella reviews on epidemiological studies has been ...observed, but there is no systematic assessment of their methodological and reporting characteristics. Our study aims to fill this gap by performing a systematic mapping of umbrella reviews in epidemiological research.
We will perform a meta-epidemiological study including a systematic review in MEDLINE and EMBASE to identify all the umbrella reviews that focused on systematic reviews of epidemiological studies and were published from inception until December 31, 2022. We will consider eligible any research article which was designed as an umbrella review and summarized systematic reviews and meta-analyses of epidemiological studies. From each eligible article, we will extract information about the research topic, the methodological characteristics, and the reporting characteristics. We will examine whether the umbrella reviews assessed the strength of the available evidence and the rigor of the included systematic reviews. We will also examine whether these characteristics change across time.
Our study will systematically appraise the methodological and reporting characteristics of published umbrella reviews in epidemiological literature. The findings of our study can be used to improve the design and conduct of future umbrella reviews, to derive a standardized set of reporting and methodological guidelines for umbrella reviews, and to allow further meta-epidemiological work.
osf.io/sxzc6.
Abstract
There is emerging evidence that the Italian population is switching away from the traditional Mediterranean dietary pattern towards unhealthy eating habits. We derived adults’ dietary ...patterns (DP) using a principal component analysis (PCA) on food groups intake of a representative sample of the Italian population (INRAN-SCAI 2005-2006), and correlated diet adherence scores with sociodemographic characteristics through multivariable linear regressions. After PCA, “High-fat”, “Western”, “Health-conscious”, “Italian, traditional” and “Junk, out of meal” DPs were retained. Female gender (β = 0.5103; p < 0.001) showed an association with higher adherence scores on the Health conscious pattern. Conversely, being female was associated with lower Z-scores on the High fat (β=-0.1849; p = 0.024), Western (β= -0.0711;p= 0.004) and Italian traditional (β=-0.4799;p<0.001) patterns. Age (β per one year increase=-0.0077;p<0.001) was associated with lower adherence scores in the Western and in the Junk, out of meal (β=-0.0078;p<0.001) pattern. Having either a secondary (β=-0.1301;p=0.016) or tertiary (β=-0.2156;p= 0.001) education level were independently associated with lower dietary Z- scores in the Italian traditional” pattern. Finally, there was wide regional variation, coming from different regions predicted adherence to different DPs. A substantial share of our sample showed unhealthy eating habits, which is consistent with the latest Italian dietary trends.
Key messages
• Future policies to improve diet quality at the national level should promote food literacy interventions targeting the differences between women and man among different age groups.
• This work will provide the basis to investigate the environmental impact of higher pattern adherence scores.
Abstract
As of April 2023, over 650 million people have been confirmed to have contracted COVID-19. The risk of transmission of COVID-19 might be influenced by various factors, including immunity ...from vaccination or previous infection, the use of personal protective equipment (PPE), indoors vs. outdoors environments, the degree of ventilation in indoor environments, and distance from the source of the infection. This review aims to assess the credibility of research conducted on individual risk factor epidemiology and prevention of COVID-19. A search was conducted on PubMed to identify systematic reviews and meta-analyses of studies examining the association between individual-level exposures and COVID-19. The study estimated the summary effect size and its 95% CI using both fixed-effect and random-effects models, and the 95% prediction interval was used to evaluate uncertainty. The study also examined heterogeneity among the studies and the presence of biases. We identified 141 meta-analyses examining 84 types of exposures or treatments. These were categorized into eight macro-groups: demographic factors, behavioural factors, dietary nutrient intake, comorbidities, drugs, PPE, contact types, and vaccination. Interventional studies comprised 5.7% of the total, contact tracing studies were 9.8%, and the remaining studies (84.5%) were other types of observational comparative studies. In these preliminary findings, the heterogeneity index (I2) ranged from large to very large, and there was evidence of small study effect and excess significance bias in many meta-analyses. Preliminary findings suggest that, apart from vaccines, for which abundant randomized evidence exists, the evidence base for COVID-19 prevention consists largely of studies of low or uncertain epidemiological credibility.
Key messages
• Overall epidemiological credibility of COVID-19 association studies might be low.
• Rigorous methodological practices are recommended when conducting epidemiological studies.
AML patients (total 129; median age =50 years; range 16-72) in first CR received BU and melphalan (BU/Mel) as conditioning regimen before auto-SCT. In all, 82 patients (63.6%) received PBSCs and 47 ...patients (36.4%) received BM cells. The distribution of cytogenetic categories was conventionally defined as favorable (15.5%), intermediate (60.1%) and unfavorable (24.3%). With a median follow-up of 31 months, the 8-year projected OS and disease-free survival (DFS) was 62 and 56% for the whole population, respectively. The relapse rate was 46% and the non-relapse mortality was 4.65%. Although PBSC transplantation led to a faster hematological recovery than BM transplantation, in univariate analysis the stem cell source, cytogenetics and different BU formulations did not significantly affect OS and DFS, whereas age and the number of post-remission chemotherapy cycles did have a significant effect on the clinical outcome. Multivariate analysis identified age <55 years as the only important independent predictor for OS and DFS. Our data suggest that BU/Mel, being associated with a low toxicity profile (mainly mucositis) and mortality, is an effective conditioning regimen even for high-risk AML patients in first CR undergoing auto-SCT.
OBJECTIVE: Our purpose was to describe placental lesions associated with normal and abnormal fetal growth in infants delivered for obstetric indications at <32 weeks' gestation.
STUDY DESIGN: ...Maternal and neonatal charts and placental tissues from 420 consecutive nonanomalous live-born singleton infants delivered at <32 weeks' gestation with accurate gestational dates were retrospectively studied. Excluded were cases with maternal diabetes, chronic hypertension, hydrops fetalis, diagnosed congenital viral infection, and placenta previa, leaving four primary indications for delivery: preeclampsia, preterm labor, premature rupture of membranes, and nonhypertensive abruptio placentae. The presence and severity of placental lesions was scored by a pathologist blinded to clinical data. Birth weight and length percentiles were calculated from published nomograms. Asymmetric intrauterine growth retardation (
n = 32) was defined as birth weight <10th percentile with length >10th percentile and symmetric intrauterine growth retardation
n = 48) as both weight and length <10th percentile for gestational age. A “growth restriction index” was developed to express a continuum of growth in both length and weight. Contingency tables, analyses of variance, and multiple regression analysis defined significance as
p < 0.05 (with corrections for multiple comparisons).
RESULTS: A greater proportion of cases with intrauterine growth retardation had lesions of uteroplacental insufficiency (
p < 0.001) or chronic villitis (
p < 0.02) than did appropriately grown preterm infants. Cases with asymmetric intrauterine growth retardation tended to have more lesions than did cases with appropriate-for-gestational-age infants. Four multiple regression analyses used the growth restriction index as outcome and the histologic lesions that had significant relationships to fetal growth as independent predictors in univariate analyses. Overall, uteroplacental fibrinoid necrosis, circulating nucleated erythrocytes, avascular terminal villi, and villous infarct were significant independent predictors of fetal growth (adjusted
R
2 = 0.312). With addition of preeclampsia as a variable, villous fibrosis, avascular villi, infarct, and preeclampsia were independent predictors of fetal growth (adjusted
R
2 = 0.341). In the 65 preeclampsia cases no histologic lesion was an independent predictor of fetal growth, whereas in the nonpreeclampsia cases, villous fibrosis and avascular villi were independent predictors of fetal growth (adjusted
R
2 = 0.075).
CONCLUSIONS: In nonanomalous preterm infants intrauterine growth retardation is most commonly symmetric and is primarily related to the cumulative number and severity of lesions reflecting abnormal uteroplacental or fetoplacental blood flow. The growth restriction index may contribute to the study of the biologic range of fetal growth. The statistical relationship of most placental lesions to intrauterine growth retardation depends on the presence or absence of preeclampsia.
Placental pathologic features of preterm preeclampsia Salafia, Carolyn M.; Pezzullo, John C.; López-Zeno, JoséA. ...
American journal of obstetrics and gynecology
173, Številka:
4
Journal Article, Conference Proceeding
Recenzirano
OBJECTIVE: Our purpose was to compare the incidence and interrelationships of uteroplacental vasculopathy and chronic inflammatory and placental vasoocclusive lesions in preeclampsia and spontaneous ...delivery before 32 weeks' gestation.
STUDY DESIGN: Review of singleton live-born nonanomalous infants born at 22 to 32 weeks' gestation identified 76 cases of preeclampsia and 353 cases of spontaneous prematurity (spontaneous premature membrane rupture
n = 192, preterm labor, intact membranes
n = 161). Histologic lesions were considered as belonging to one of five major pathophysiologic groups: (1) uteroplacental vascular lesions and related villous lesions, (2) chronic inflammatory lesions, (3) coagulation-related lesions, (4) acute inflammatory lesions, and (5) unclassified lesions. Contingency table analyses considered
p < 0.05 significant. Factor analysis extracted combinations of related variables.
RESULTS: More frequent in preeclampsia versus spontaneous prematurity were chronic uteroplacental vasculitis (29% vs 20%,
p < 0.05), chronic villitis (20% vs 3%,
p < 0.001), avascular villi (39% vs 16%,
p < 0.001), and “hemorrhagic endovasculitis” (9% vs 2.5%,
p < 0.03). In the preeclampsia cases factor analysis extracted 13 categories of related lesions. Four categories contained uteroplacental vascular lesions. Five categories included lesions related to chronic inflammation, and eight included lesions related to coagulation. Four categories loaded lesions from one major pathophysiologic group only. Three categories loaded lesions from all three pathophysiologic groups. Unclassified lesions loaded into two factor categories that were unrelated to the other lesions.
CONCLUSIONS: Chronic inflammatory and placental vasoocclusive lesions are more common in preterm preeclampsia than in spontaneous prematurity. Immunopathologic processes and coagulation may be involved in the pathophysiologic mechanisms of preterm preeclampsia independent of uteroplacental vascular pathologic features.
Gastrointestinal disorders are common in elderly patients, and the clinical presentation, complications, and management may differ from those in younger patient. Most impairment occurs in the ...proximal and distal tract of the gastrointestinal system. Swallowing abnormalities with a wide span of symptoms and pelvic floor pathologies involving all the pelvic compartments are common. Acute abdomen, often from small bowel obstruction or mesenteric ischemia, can pose a diagnostic challenge, because a mild clinical presentation may hide serious visceral involvement. In this setting, the radiologist often is asked to suggest the appropriate management options and to guide the management.
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